Connecticut Science Educators Conference Presenter Application 2017
Please fill out the information below to apply to present at this year's annual Connecticut Science Educators Conference on Saturday, November 18th 2017. Application deadline Friday, June 2nd.
First Name
Your answer
Last Name
Your answer
Street Address
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City
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State
Zip Code
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Primary Email Address
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Secondary Email Address
Your answer
Presenter Type (Please select your institution type and provide the name in the "other" column)
Required
Will you have a co-presenter?
Co Presenter First Name
Your answer
Co Presenter Last Name
Your answer
Co Presenter Address
Your answer
Co-Presenter City
Your answer
Co-Presenter State
Co-Presenter Zip Code
Your answer
Co-Presenter Primary Email Address
Your answer
Co-Presenter Secondary Email Address
Your answer
Workshop Title
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Description for Conference Program (50 word maximum)
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Write a more detailed description to help the Program Committee evaluate your proposal.
Your answer
List applicable NGSS core ideas, practices, and/or crosscutting concepts your presentation will address.
Your answer
Topic Area (check all that apply)
Required
Workshop Level (please check all that apply)
Required
Room Requirements (please check all that apply)
Required
Please explain any potential safety hazards, lists of reagents, biohazard details, and/or animals you are planing on bringing or using during your workshop.
Your answer
What precautions or safety equipment, if any, will you be using in your room? (All equipment must be provided by the presenter)
Your answer
Thank you!
* If your proposal is accepted, all presenters will be required to fill out a safety contract and register for a discounted conference rate of $25.00.
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