Presenter Form 2017-2018
On behalf of SMHCA and the Program Development Committee, we are delighted you are interested in presenting to the counseling community in Tampa Bay. Please complete the document below and submit. Thanks for your interest and we will get back to you regarding your submission.

Sincerely,
Cristina Gonzalez, Registered Mental Health Counselor Intern
Program Development Chair

Email address *
Full Name *
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Credentials
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Practice or Organization
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Webpage Address
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Title and relevance of your topic to mental health counselors *
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Please identify 3-5 objectives you hope to accomplish during your presentation: *
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Please indicate the type of AV equipment and/or props you will need for your presentation besides a projector and computer with are available on location: (Please do not bring any flammable props (e.g. candles, incense). *
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