We recommend you type and save this information in Microsoft Word or another word processing program and then copy it into this form. You will receive notification regarding your program's status by February 13, 2008. If at any time you have questions about submitting your program proposal, please contact Beth Moriarty at bmoriarty@bridgew.edu or 508.531.1277.

Before you begin, we recommend you have the following information available:

• Contact Information for all presenters
• Program Title
• Program Abstract (75 word limit)
• Program Description - Including an introduction, relevant conceptual/theoretical basis, method of presentation, and learning objectives and outcomes.

PROGRAM TITLE
CONTACT PERSON
Name
Title
Institution
Address
City/State/ZIP
Telephone	(Format: 508-531-1277)
Fax
E-Mail Address	(Any further correspondence will be sent to this address.)
ADDITIONAL PRESENTER INFORMATION
Name
Institution
Name
Institution
Name
Institution
Name
Institution
Note: If there are more than five presenters, please submit their information separately to Beth Moriarty at bmoriarty@bridgew.edu.

PROGRAM ABSTRACT

Please submit a 75 word or less abstract describing your program. If your program is selected, this abstract will be published in the program schedule.

PROGRAM DESCRIPTION

Please also submit a detailed description of your program including: an introduction, relevant conceptual/theoretical basis, method of presentation, and learning objectives and outcomes.

PROGRAM INFORMATION
Program Focus (Check all that apply)
New Professionals	Undergraduate Students
Graduate Students
Is their a maximum number of participants you can accommodate?
Yes, How many? No
Audio-Visual/Technology Needs (Check all that apply)
Blackboard/Dry Erase Board	Easel
Overhead Projector	LCD Computer Projector
TV/VCR Unit	TV/DVD Unit
Computer	Internet Connection

Specific Requests:
Will you be bringing your own laptop?	Yes No

Last Modified: July 15, 2008