2015 PASE@PACE Conference Workshop Form
Please complete this form to present at the 2015 PASE@PACE Conference. Submissions due May 20, 2015 at 5:00 pm (EST) (extended deadline). Selected presenters will be notified by June 5, 2015.
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Lead Presenter Information
Conference fee is waived for lead presenter and one co-presenter.
First Name *
Last Name *
Job Title *
Email *
Phone Number *
e.g. 555-555-5555
Event Day Phone Number *
e.g. 555-555-5555
Organization (if applicable)
Website (if applicable)
Twitter (if applicable)
Have you presented at our conference before? *
Bio *
250 Word Limit
Co-Presenter Information
Complete this section if your workshop will include a co-presenter. Conference fee is waived for one co-presenter.
Co-Presenter First Name
Co-Presenter Last Name
Co-Presenter Job Title
Co-Presenter Email
Co-Presenter Organization (if applicable)
Co-Presenter Twitter (if applicable)
Co-Presenter Bio
250 Word Limit
Workshop
Workshop Title *
Workshop Format *
Please select the primary format of the workshop
Workshop's Intended Audience(s) *
 Check all that apply
Required
Workshop content addresses the following age group(s): *
Check all that apply
Required
Workshop Theme *
Workshop Description *
500 word maximum
Workshop Outcomes
Please specify three outcomes of your workshop. As a result of this workshop, participants will...
Outcome 1 *
Outcome 2 *
Outcome 3 *
Additional Information
Are you interested in presenting this topic more than once? *
During which time slot(s) are you available to present? *
Check all that apply
Required
A/V Equipment *
Workshop rooms come with the following A/V equipment - desktop computers (PC only), projector, screen and access to wifi. Please indicate which, if any, you will need.
Required
Thank You!
Please print out a copy of your completed form before clicking "submit."
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