TASP/IPA 2016 Conference Proposal
Name of Primary Presenter or Session Chair *
Your answer
Mailing Address of Primary Presenter or Session Chair *
Your answer
City or Town
Your answer
State or Province of Primary Presenter or Session Chair *
Your answer
Zipcode of Primary Presenter or Session Chair *
Your answer
Country of Primary Presenter or Session Chair *
Your answer
Email Address of Primary Presenter or Session Chair *
Your answer
Phone Number of Primary Presenter or Session Chair *
Your answer
Institutional Affiliation of Primary Presenter *
Your answer
Position of Primary Presenter or Session Chair
e.g. Associate Professor, Director, Playworker, Therapist
Your answer
Name of second presenter
Your answer
Email of second Presenter
Your answer
Institution of second presenter
Your answer
Name of third presenter
Your answer
Email of third presenter
Your answer
Institution of third presenter
Your answer
Name of fourth presenter
Your answer
Email of fourth presenter
Your answer
Institution of fourth presenter
Your answer
Any additional presenters
please write in name, institution, and email address
Your answer
Presentation Format *
There are four types of presentation formats. Please choose one.
Presentation Focus
Select all that apply
Would you be interested in presenting your work to a diverse group of conference attendees AND local youth, parents, and community leaders?
Title of Presentation *
Your title must be no more than 20 words
Your answer
Presentation Abstract *
Your proposal must be no more than 200 words.
Your answer
Program Description *
A 50 word or less description for the program. This will not be edited, so please make sure it describes your session how you would want it to appear in the program.
Your answer
Presenter Bios *
Include a bio of no more than 75 words for EACH presenter. Only presenters with bios will be included in the program
Your answer
Audio-visual needs *
Select all that apply. We will try and accommodate all requests. However, you must include your audio-visual needs here, we might not be able to accommodate late requests.
Required
Preferred day of presentation
We will try and accommodate all preferences, but we cannot guarantee a particular day or time
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