Call for Participation

Presentation Title:

If more than one presenter, designate the lead presenter.

First Name:

Last Name:

Institution/Company:

Address:

City:

Country: --- Select Country --- Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo, The Democratic Republic Of The Cook Islands Costa Rica Croatia Cuba Cyprus Czech Republic Côte D'Ivoire Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard and McDonald Islands Holy See (Vatican City State) Honduras Hong Kong Hungary Iceland India Indonesia Iran (Islamic Republic Of) Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Korea, Democratic People's Republic Of Korea, Republic of Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macao Macedonia, the Former Yugoslav Republic Of Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States Of Moldova, Republic Of Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territory, Occupied Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Romania Russian Federation Rwanda Réunion Saint Barthélemy Saint Helena Saint Kitts And Nevis Saint Lucia Saint Martin (French part) Saint Pierre And Miquelon Saint Vincent And The Grenedines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands Spain Sri Lanka Sudan Suriname Svalbard And Jan Mayen Swaziland Sweden Switzerland Syrian Arab Republic Taiwan, Province Of China Tajikistan Tanzania, United Republic of Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Venezuela Viet Nam Virgin Islands, British Virgin Islands, U.S. Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Åland Islands

State: --- Select a State --- Alaska Alabama Arkansas Arizona California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming

Zip/Postal Code:

Phone:

Summer Phone:

Fax:

E-mail:

Website URL:

Will there be any additional presenters? Yes No

Please provide complete contact information, including e-mail, for each additional presenter. List only those persons who will actually attend and present at the conference.

Have you or any co-presenter(s) presented this proposal before? Yes No

Please indicate when and where:

Will you or any co-presenter(s) submit this proposal to or present this proposal at any other national conference in 2010? Yes No

Please indicate what conference, when and where:

The content of this session is supported by evidence and references are provided. Yes No

This session includes quantitative performance data. Yes No

Type of presentation:

Are you or any co-presenters affiliated in any manner with a company or organization whose commercial products you will be presenting or demonstrating? Yes No

If this is a product demonstration, is the product available for purchase at this time? Yes No

Length of presentation: 1 hour 2½ hours

Audience computer sophistication level: Beginner Intermediate Advanced N/A

Presentation subject sophistication level: Beginner Intermediate Advanced All

If you supply your own laptop computer, it is necessary for you to list the make and model:
Laptop Make and Model:

Note: If you plan to connect to the Internet with your laptop, please provide a wireless networking card.

Have you selected all the appropriate subjects for your presentation?
Yes.
No, show me the full list.

Learning Outcomes: As a result of this activity, participants will be able to:

(Check the CEU area of the AAC Institute Web site for appropriate verbs to be used for learning outcomes statements. <www.aacinstitute.org>)

Primary focus of presentation: (Please be specific)