Presentation Proposal Form If presentation has more than one presenter, identify the lead. Correspondence for selected presentations will be sent to the lead presenter. It is the lead presenter’s responsibility to disseminate all necessary material or information to the other presenters in the group. Presentation We suggest 10 words or less. Title General Advanced   Level of Practice the session is geared towards Intermediate All practice levels   Track Administrative Clinical Student General Interest     Substance Cross Cross Cultural Alaska    – Specific Ethics  Abuse Cultural Native Specific Presenter(s) Name Lead (if applicable)   Yes No Agency/Organization: Job Title: Academic Degree(s): Credentials & License #/State (if applicable): Mailing Address Work Phone Home Phone Cell Phone Co-Presenter’s Name(s) (if applicable) Agency/Organization: Job Title: Academic Degree(s): Credentials & License #/State (if applicable): Mailing Address: Work Phone Home Phone Cell Phone Email Work Number Home Number Cell Phone
Presentation Proposal Form If presentation has more than one presenter, identify the lead. Correspondence for selected presentations will be sent to the lead presenter. It is the lead presenter’s responsibility to disseminate all necessary material or information to the other presenters in the group. Presentation We suggest 10 words or less. Title Level of Practice the session is geared towards  General  Intermediate  Advanced  All practice levels Track  Administrative  Clinical  Student  General Interest Specific  Ethics  Substance Abuse  Cross Cultural  Cross Cultural – Alaska Native Specific Presenter(s) Name Lead (if applicable)  Yes  No Agency/Organization: Job Title: Academic Degree(s): Credentials & License #/State (if applicable): Mailing Address Work Phone Home Phone Cell Phone Co-Presenter’s Name(s) (if applicable) Agency/Organization: Job Title: Academic Degree(s): Credentials & License #/State (if applicable): Mailing Address: Work Phone Home Phone Cell Phone Email Work Number Home Number Cell Phone
Call+for+Presentations.docx