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Online Workshop Proposal Submission Form
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Complete online form and submit electronically by clicking on the submit button below.
Please complete the form in its entirety. Incomplete proposals will not be selected. By
submitting proposal, you agree that any information submitted (excluding contact
information) may be printed in conference program or other conference publications.
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Submission Deadline: August 15, 2010 EXTENDED TO SEPTEMBER 15, 2010
Selected Presenters will be notified by September 30, 2010.
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Selected presenters will receive a discounted conference
registration rate of $30.00 (early fee), if attending conference.
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Contact Information: The lead presenter will serve as the main contact person and
will receive all correspondence.
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Your Name:
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Job Title:
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Agency/Organization:
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Mailing Address:
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City/State/Zip:
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Phone Number:
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Fax Number:
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Email Address:
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Your Profile: Provide a brief biographical summary including education and
presentation/training experience.
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Additional Presenter(s) Information:
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List Name and Agency/Organization of each presenter:
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Additional Presenter Profile(s):Provide a brief biographical summary including
education and presentation/training experience for each additional presenter.
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Workshop Information:
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Workshop Title:
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Workshop Length:
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1.5 Hours
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3.0 Hours
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Yes
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No
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Can Repeat Workshop:
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Date(s) and Time(s) Available (Check all that apply):
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Nov. 19: 08:30 a.m.-10:00 a.m.
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Nov. 18: 10:30 a.m.-12:00 p.m.
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Nov. 18: 01:30 p.m.-03:00 p.m.
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Nov. 19: 10:30 a.m.-12:00 p.m.
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Nov. 18: 03:15 p.m.-04:45 p.m.
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Workshop Description for Conference Program (25-75 Words):
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Workshop Learning Objectives (Please list as least 3 objectives):
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Workshop Content (Intended Format such as lecture, open discussion,
or panel discussion and Outline of Material to be presented):
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Intended Audience (Check all that apply):
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Tribal Child Welfare Workers
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Educators
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Foster Parents
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State Child Welfare Workers
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Advocates
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Tribal Leaders
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CPS Workers/Investigators
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Judges
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Policy Makers
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Supervisors/Administrators
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Attorneys
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Law Enforcement
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Mental Health Providers
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Domestic Violence Advocates
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Substance Abuse Providers
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Other: Please List
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Audience Level for Learning:
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Entry Level (0-1 Yrs.)
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Intermediate (2-5 Yrs.)
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Advanced (5+ Yrs.)
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Workshop Track:
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Legal: Topics related to ICWA (e.g., training, compliance, active efforts) and
tribal and state court processes (e.g., worker preparation, testifying).
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Cultural: Topics related to tribal cultures, traditions, and customs and working
with Indian children, families, and ICW programs.
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Health/Wellness: Topics related to the mental and physical health of children,
families, and caseworkers.
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Practice/General:Topics related to child welfare practice, strategies, resources,
and collaboration.
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Audio/Visual Needs (Presenter must supply own computer laptop if required.
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Screen &
A/V Cart
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VCR Player
& Monitor
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Easel/Markers
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LCD Projector
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Pursuant to the Americans with Disabilities Act, do you or
additional presenter(s) require specific aids and/or services?
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Yes
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No
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If yes, please describe:
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Please click Submit after all fields have been completed. Submission is
not complete until you are directed to a confirmation web page screen.
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