2019 PSAHPERD Convention Session Proposal
December 5&6 Spooky Nook
Session Proposal Form due by Friday, April 13, 2019
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
Captionless Image
Required
Please select the target audience that BEST describes the focus of your presentation. *
Speaker 1 Information
Please include the following information for each speaker.
Name *
First & Last Name
Your answer
Title
e.g. M.Ed., Ed.D if you want it listed
Your answer
What best describes you? *
School / Agency *
Your answer
Mailing Address *
Street Address, City, State, Zip
Your answer
Phone *
(111) 555-1212
Your answer
Email *
Your answer
Is the contact information listed above for work or home? *
Have you presented at a PSAHPERD Convention/Event before? *
If you answered YES to the above question, please list up to 3 most recent presentations with PSAHPERD. If you answered NO, please type "N/A."
Your answer
Have you ever received a Teacher of the Year Award?
Check all that apply. If no, skip this question.
If you answered yes to the above question, what year did you receive this award?
Your answer
Speaker 2 Information
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
Is the contact information listed above for work or home?
Have you presented at a PSAHPERD Convention/Event before?
If you answered YES to the above question, please list up to 3 most recent presentations with PSAHPERD. If you answered NO, please type "N/A."
Your answer
Have you ever received a Teacher of the Year Award?
Check all that apply. If no, skip this question.
If you answered yes to the above question, what year did you receive this award?
Your answer
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
If you selected yes to the above question, please explain.
Please note: PSAHPERD will only pay for sessions offering certifications, books or materials that participants receive. (Receipts must be submitted)
Your answer
What best describes the activity level involved in presentation *
Check all that apply
Required
Speaker Terms
By featuring you and your peers as presenters, PSAHPERD provides convention attendees with a professional platform for information exchange, problem solving, and networking on the state level.

Presenters are required to register for the convention, and will receive a 50% discount on their chosen registration type for up to 2 registrations.

Presenters will be limited to a maximum of two presentations unless requested by the committee to submit additional proposals. Maximum of 2 speakers per session.

Speakers are required to provide an electronic informational handout prior to the convention and if applicable, include an assessment tool for student learning.

Proposals received by the March 16th deadline will be reviewed by the convention planning committee. Your proposal will be evaluated on the following:

1. Overall quality and innovation of presentation
2. Practical application of information/materials
3. Application to PA State Standards
Please check here to acknowledge you read and understand the speaker terms.
Questions:
Programing questions can be directed to pa2019proposals@gmail.com
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