PRESENTER PROPOSAL FORM
PLEASE SUBMIT BY OCTOBER 2, 2009
SEE TOPICS ALREADY SUBMITTED!
 
Name - First:    Last:   
Street Address:
City:    State:     Zip: 
School or Business Name:
If this is a vendor presentation, only exhibiting vendors will be considered.
School or Business Address:
City:    State:    Zip:
Home Phone:    Work Phone:  Fax:
Email:
Type of Presentation:
Hands On Lab Preference:
Suggested Audience:
Presentation Days:
Co-Presenters Information: Please include names, email, and affiliation.
Co-Presenter #1    
First Name
 Last Name
 Preferred Email
Affiliation
Co-Presenter #2    
First Name
 Last Name
 Preferred Email
Affiliation
Co-Presenter #3    
First Name
 Last Name
 Preferred Email
Affiliation
Co-Presenter #4    
First Name
 Last Name
 Preferred Email
Affiliation
Co-Presenter #5    
First Name
 Last Name
 Preferred Email
Affiliation

 
Title of Presentation:  
 
Description of Presentation: Please describe your presentation in 50 words or less for program 
 
Internet Access:

Acceptance of your proposal will be acknowledged by email only.
Please email sheryl.abshire@cpsb.org or call Sheryl Abshire, LACUE Program Chair at 337-217-4100 ext. 1001 if you have any problems submitting your proposal.