2019 CISC Leadership Symposium Presenter Application
Email address *
Lead Presenter First and Last Name *
Your answer
Lead Presenter Title *
Your answer
Lead Presenter Organization *
Your answer
Your Organization exists in which County? *
Your answer
Lead Presenter Cell Phone Number *
Your answer
Lead Presenter Bio (100 - 200 words) *
Your answer
Co-Presenter(s) Name (if applicable)
Your answer
Co-Presenter(s) Title, Organization
Your answer
Session Title *
Your answer
Short Description for Session (30 - 50 words) *
Your answer
Detailed Description for Session (2 - 3 paragraphs). Please include session objectives, alignment to conference theme/strands and strategies that will be employed to engage session participants *
Your answer
Session Length *
Your answer
Could your session be adapted to shorten or lengthen if necessary? *
To which conference strand(s) does this session align? *

1. By submitting this proposal, I understand and agree that all presenters are required to register for the conference and pay the registration fee.

2. For consistency and space purposes, I understand and agree that CCSESA reserves the right to edit proposed presentation titles and descriptions.

3. I understand and agree that during and/or following the conference, CCSESA may share my presentation with its members via the Internet and through other means.

4. I affirm that I own or otherwise have the right to use the proposed content. I further affirm that I have the right to give consent to publish the content. By submitting this form, I grant CCSESA permission to share my presentation with its members.

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