ANNUAL Education 2018 Session Form
The Education session form is submitted ONCE for each ANNUAL education session and is the only form submitted. Please open this form prepared to submit all of the information requested, most questions REQUIRE an answer. This is the only method by which to submit education session information. What you submit is EXACTLY what will be published. Thank you!
Education Session Information
Session Title *
Your answer
Session Time of Year *
Please list any specific dates on which the speaker would like to have the class (if applicable).
Your answer
Length of session *
Session length is based on CPE credits and should stick with the lengths listed.
Please indicate if there is a preference for AM or PM (if applicable).
Preferred Locations *
Please list any specific locations (with a contact name, phone and email for the location) you or the speaker thinks would be a good host site for this class.
Your answer
Session Description *
Describe the session well enough so that attendees can decide whether or not to attend. This description will be published.
Your answer
Session Outcomes and Objectives *
This is used for assessing CPE credits.
Your answer
Session Major Topics covered *
This is used for assessing CPE credits.
Your answer
Session Level *
Additional AV / Engineering Needs *
The room will have an LCD projector, screen (or white wall) and front table or podium. Please indicate all additional items you will need, i.e. easel, pad, Mac adaptor, internet access, etc.
Your answer
Speaker Information
Number of Speakers *
Speaker #1 First Name *
Your answer
Speaker #1 Last Name *
Your answer
Speaker #1 Title *
Your answer
Speaker #1 Organization *
Your answer
Speaker #1 Biography - Narrative *
Your answer
Speaker #2 First Name
Your answer
Speaker #2 Last Name
Your answer
Speaker #2 Title
Your answer
Speaker #2 Organization
Your answer
Speaker #2 Biography - Narrative
Your answer
Speaker #3 First Name
Your answer
Speaker #3 Last Name
Your answer
Speaker #3 Title
Your answer
Speaker #3 Organization
Your answer
Speaker #3 Biography - Narrative
Your answer
Moderator Information
Moderator First Name *
Your answer
Moderator Last Name *
Your answer
Moderator Title *
Your answer
Moderator Entity/Organization *
Your answer
Moderator Phone # *
Your answer
Moderator Email Address *
Your answer
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