Teaching aNd Technology10 Institute

Complete the form below to apply:
**All presenters and co-presenters MUST REGISTER for the conference**

First Name
 Last Name
 Job Title
Affiliation (School/Department/University/Company, etc.)
Home Address
City
 State
 Zip
Work Phone
 Home Phone
Fax Number
 Preferred Email Address

Proposal Information:

Format of session (Choose one):
Concurrent (1 hour)
This will be in a classroom or conference room with lecture style seating for 30-50 participants.
 		 Hands-on Workshop (1 hour)
This will be in a PC computer lab with 20-30 computers and a computer connected to a projector.

Title of Proposal (10 words or less)

Description:  (accurate, appealing description for use in the program; 25 words or less)

Intended audience:

Audience Knowledge/Experience Level:

All Beginning Advanced

Internet, and Other Needs

Each presenter will need to bring a laptop to use for presenting in their sessions or lab.  Hands-on labs will have computers for lab participants.
All session rooms will have a projector to hook-up to your laptop.

For presentation check your needs:

Internet required (Internet will NOT be wireless in presentation rooms)

No Internet needed

Additional equipment requested:

VCR with monitor

Please list any SOFTWARE or INTERNET PLUG-IN needed: (Please include the version number)
ex: Office 2000, Office XP, Shockwave, etc.

We will not provide any additional equipment but please list any HARDWARE you will be bringing that will need to connect to lab computers: (Digital Cameras, Digital Video Cameras, Microscopes, etc.)

Are you willing to make your presentation twice?

Yes

No

Co-Presenters
If you would like your co-presenters to be listed in the program, please supply each co-presenter's name & email address below:

First Name
 Last Name
 Preferred Email
First Name
 Last Name
 Preferred Email
First Name
 Last Name
 Preferred Email
First Name
 Last Name
 Preferred Email
First Name
 Last Name
 Preferred Email

Is this a VENDOR presentation?

 Yes  No

If YES, what company do you represent?

Questions, please contact:
Sheryl Abshire, CPSB Technology Training Center
600 S. Shattuck St., Lake Charles, LA 70601
Email:  sheryl.abshire@cpsb.org
Fax:  337.217.4101

If my proposal is accepted, I agree to present the above session on Saturday, October 18th at time(s) to be assigned.

I agree I disagree