Call for Presenters - Fond Du Lac Tribal and Community College
Call for Presenters - Fond Du Lac Tribal and Community College
Call for Presenters - Fond Du Lac Tribal and Community College
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32 nd Annual<br />
Minnesota American Indian Institute on Alcohol <strong>and</strong> Drug Studies<br />
July 29 - August 2, 2013<br />
<strong>Fond</strong> du <strong>Lac</strong> <strong>Tribal</strong> <strong>and</strong> <strong>Community</strong> <strong>College</strong><br />
Presentation In<strong>for</strong>mation:<br />
Presentation Proposal Form<br />
Title of presentation (No more than 7 words) _________________________________________________________<br />
Workshop <strong>for</strong>mat (circle one): Lecture Discussion H<strong>and</strong>s-on Active Other? _________________<br />
Workshop duration (circle one): SINGLE session~1.25-1.5 hours DOUBLE session~2.75 hours (limited avail)<br />
Do you need to limit the number of participants? YES NO<br />
Will you have h<strong>and</strong>outs or other materials <strong>for</strong> participants? YES NO<br />
Do you need to charge a materials fee? NO YES Amount: $______________<br />
Do you have any special space needs <strong>for</strong> your workshop? (For example: open space, talking circle set up, room made<br />
dark <strong>for</strong> slides, electricity, running water, etc.) _________________________________________________________<br />
_______________________________________________________________________________________________<br />
_______________________________________________________________________________________________<br />
Audio/Visual Needs (indicate all that apply):<br />
Computer/PowerPoint Projector (Presentations must be sent via email or saved to CD ROM)<br />
TV/VCR<br />
Whiteboard<br />
Large tablet <strong>and</strong> easel<br />
Overhead projector (<strong>for</strong> use with transparencies)<br />
Other (please specify) __________________________________________________________<br />
Preferred date of presentation<br />
1 st Choice Date ______________________________ Time _______________________________<br />
2 nd Choice Date ______________________________ Time _______________________________<br />
3 rd Choice Date ______________________________ Time _______________________________<br />
Presenter In<strong>for</strong>mation:<br />
How many people will present this session? ___________________________________________________________<br />
Provide contact/background in<strong>for</strong>mation <strong>for</strong> each presenter. Please list the Main Contact/Lead Presenter first,<br />
followed by in<strong>for</strong>mation on each co-presenter.<br />
Instructor name (as you would like printed in program) ___________________________________________<br />
Professional Title: ________________________________________________________________________<br />
Work Agency: ___________________________________________________________________________<br />
Address: ________________________________________________________________________________<br />
City: __________________________________________ State: __________ Zip: _____________________<br />
Phone: ____________________________________ Fax: ________________________________________<br />
Email: _________________________________________________________________________________
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