Workshop Proposal Submission If you are a human and are seeing this field, please leave it blank. Fields marked with an * are required Name of Presentation * Description of Presentation * Name of Presenter(s) * Please include a short bio for each presenter to go in the program book (no more than 25 words for each) * Is this a self-advocate led workshop? * YesNo I understand that the conference will NOT be supplying audio-visual equipment (LCD projectors, overhead projectors, and computers). If you do require this please make sure you make your own arrangements or indicate what you require in the stipend section. * Do you require a speaker fee? * No, this will be a volunteer presentationYes, I will need a stipend If you require a stipend (including equipment, conference attendance or hotel stay) what is it? What method of presentation will you use? (please check all that apply) * MusicDiscussionParticipatory exercisePowerpointVideo/DVD Do you have a room setup preference? * RoundsTheater StyleLarge CircleNo PreferenceOther (please provide detail at the end of this form under "additional information") Who is the primary contact person * Group/Organization/Agency Address (City, State, Zip) * Phone # * Email address * Would you like to provide us with any additional information?