2019 KIDS COUNT Conference Breakout Session Proposal Form
Email address *
Application for Conference Presentation
Applications must be emailed to fcouncil@nmvoices.org by 5PM on April 1, 2019.

If you DO NOT receive an email confirmation that we received your proposal within five business days of submission, contact fcouncil@nmvoices.org.

Presentations are currently planned to be 60 minutes in length.
ALL SESSIONS SHOULD ALLOW TIME FOR at least 10 minutes of Q&A.

It should be noted that attendance for individual sessions can range from 30 to more than 70 participants. Sessions that seek to have a small group and/or group activities CANNOT BE GUARANTEED AND CAPPING IS NOT ALLOWED. Rooms will be pre-set in theatre style (chairs only) and cannot be re-arranged.

Proposal Title (15 words max) *
I. PERSONAL INFORMATION: NAME, CREDENTIALS, CONTACT INFORMATION
Name of person submitting application: *
Contact phone: *
Contact email: *
Lead presenter name & credentials (You'll be asked to upload resume/CV in a following section): *
Area of specialization: *
Organization and Title: *
Email: *
Address: *
City/State/Zip: *
Phone: *
Phone 2: *
Names of Additional Presenters (if relevant):
Have you presented to a group of 30 or more people? *
Is this your only submission? If no, please list titles of other(s): *
Required
II.PRESENTATION TYPE
*
Required
Other (explain in 250 words or less)
III.PRESENTATION THEME
*
Other (explain in 250 words or less)
IV. PRESENTATION CONTENT
A completed application must contain the following information filled in on this page. Attachments are not necessary and will not be accepted for review.
Presenter(s) Resume/CV(s) *
Required
Presenter(s) Biographies (150 words for each presenter). *
Required
Presenter(s) High Resolution Photos *
Required
Participant Learning Objectives (list two to four objectives). *
Presentation Abstract/Summary (500 words or less). *
Brief Presentation Description (for event program selected, 150 words or less). *
Material & Equipment Needs (150 words or less). *
Plan for implementing adult learning methods in presentation, including innovative and interactive audience engagement (300 words or less). *
Description of how workshop will leverage research and an examination of current practices in topic area (200 words or less). *
Draft Session Agenda or Plan (200 words or less). *
APPLICATION CHECKLIST *
Required
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