NCSCE 2014 Washington Symposium Proposal Form

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Name *

Institution/Organization *

Title *

Department/Area of Study *

Email Address *

Phone Number *

I am a(n): *

Educator

Administrator

Student

Other:

I am proposing a:

Poster

20-minute presentation

1-hour panel presentation

Provide a title and 300-word abstract for your presentation. *

This should be suitable for publication in conference materials and should describe your project and any resulting conclusions or next steps.

Panelists, Collaborators and Co-Authors

Please use this space to list all co-authors, collaborators, and panelists, including those unable to be at the Symposium. Provide name and institutional affiliation for each. (All collaborators in attendance must register for the conference separately.)

NCSCE can offer you help in arranging a meeting with your congressional representative to tell him or her about the work you are doing to improve education for their constituents. Any meeting would take place on the morning of September 30, just prior to the Capitol Hill Poster Session. Would you like NCSCE to try to arrange a meeting for you? *

Yes

If yes, do you have a preference as to which Representative or Senator your meeting is arranged with? Please note that NCSCE can only arrange one meeting per person/group. If you have a preference, please provide that name here.

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