Title of Presentation (as it is to appear in the program - please limit to 8 words):

Description of Presentation (30 words maximum)

Format of Presentation Session (60 min.) Workshop (90 min.) Mini-Course (3 hrs.)

Level/Grade (select one) Elementary (K-4) Middle (5-8) Senior High (9-12) College Teacher Education General Interest

First Choice for Date for Presentation Thursday, November 6 Friday, November 7

Are you willing to preside at another presentation? Select One Session Workshop Minicourse Not to Preside

Audio-Visual Needs (we are only able to provide overhead projectors and screens; everything esle is the responsibility of the presenter)

Speaker Name

Position (teacher, supervisor, etc.)

School/Business Affiliation

Contact Information:

Address

City State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming ZIP

email (year-round)

Phone: