2017 PSAHPERD Convention Session Proposal
November 16-19, 2017
Valley Forge Casino Resort

Session Proposal Form due by Friday, March 10, 2017

PSAHPERD 2017 THEME
Session Title
Your answer
Description for Program & Brochure
25 words or less
Your answer
Speaker Information
One paragraph biography of speaker(s) including summary of qualifications.
Your answer
PA Academic Standard Grade Band
Please choose grade level band for the standards you are selecting and check all that apply. To view standards from PDE website, click the following link: https://goo.gl/Dg6Yx2
Required
PA State Academic Standards Addressed
Please check all that apply. To view standards from PDE website, click the following link: https://goo.gl/Dg6Yx2
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Required
Danielson Framework of Teaching
Please check all that apply
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Required
Speaker 1 Information
Please include the following information for each speaker.
Is speaker # 1 a member?
Name
First & Last Name
Your answer
Title
e.g. M.Ed., Ed.D if you want it listed
Your answer
School / Agency
Your answer
Mailing Address
Street Address, City, State, Zip
Your answer
Phone
(111) 555-1212
Your answer
Email
Your answer
Speaker 2 Information
Is speaker # 2 a member?
Name & Title
e.g. M.Ed., Ed., etc.
Your answer
School / Agency
Your answer
Mailing Address
Street Address, City, State, Zip
Your answer
Phone
(111) 555-1212
Your answer
Email
Your answer
What focus of PSAHPERD and HOW is your session showing innovation?
Please make a brief statement on how your session is showing innovation in the fields of Health, Physical Education, Recreation, Dance, Sport & Athletics, Technology, Research, Advocacy, Aquatics, Adapted Activities, Jump / Hoops for Heart, Supervision, Research, Future Professionals
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Your answer
What best describes you?
Special Instructions for Participants
Please indicate if participants in your session should bring any of the following items to maximize their participation at your session. CHECK ALL THAT APPLY.
Required
Any other special instruction for attendees?
Your answer
ONE DAY Workshop: Thursday, November 16, 2017
Complete this section ONLY if you plan to do a pre-convention full / half day workshop on Thursday. Otherwise, select "I am NOT holding a pre-convention workshop"
Length of Pre-Convention Workshop
If you are planning a half day workshop, please indicate whether you prefer AM or PM. While we cannot guarantee you preference, we will try to accommodate you. THIS YEAR WE WILL MARKET THIS AS A ONE DAY TRAINING WITH SEPARATE REGISTRATION
Is there a cost for your workshop?
If you selected yes to the above question, please explain.
Please include a brief statement about the reason for the cost. RECEIPTS MUST BE INCLUDED FOR REIMBURSEMENT TO BE ISSUED.
Your answer
Friday/Saturday 75 Minute Sessions
Preferred day/time
Days & times cannot be guaranteed, but we will do our best to accommodate preference
Research Sessions Only
Mode of Presentation
Check all that apply
Required
Preferred Arrangement
Not guarenteed, but will try to accomodate
Audio-Visual Needs
Please make a brief statement about your AV needs. Projectors and screens will be provided in each room. If you need sound systems, mics, or anything lese related to A/V, please make that request here. We will do our best to accommodate you.
Your answer
Questions:
Contact yatchyshyn.todd@penargylsd.org
Contact Linda Huber: lhuber@ptd.net OR Jessica Peconi-Cook: peconicooks@gmail.com
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