Call for Conference Workshop Submissions Speaker Application Form A form for potential conference speakers to submit course proposals Step 1 of 2 50% Name(Required) First Last Email(Required) Phone(Required)FIELD in which you earned your degree (or N/A).(Required) Licenses will be listed below.TITLE/Licenses/Certifications (or NA)(Required) Primary Organization, Company, or Institution (or NA)(Required) Co-Presenter (or NA)(Required) Presenter(s) Brief Bio(Required)Please provide a short biography highlighting your experiences in the field that qualifies you for the presentation you are proposing.Presenter CV/Resume(Required) Drop files here or Select files Accepted file types: pdf, docx, Max. file size: 50 MB. Presenter Headshot(Required) Drop files here or Select files Accepted file types: jpg, png, Max. file size: 50 MB. Please provide a short biography highlighting your experiences in the field that qualifies you for the presentation you are proposing.Consent to be recorded and to share course content(Required) Yes, I give my permission to be audio and video recorded during the Conference. I understand that video footage recorded may be made available for Conference attendees following the Conference and/or used for promotional use. No, I do not give permission for any audio or visual footage of my person to be shared during/after the Conference.ice Workshops may be audio and video recorded at the Conference to be made available following the Conference. Please select your choice above. Topics(Required) Civil Legal Services for Survivors of DV/SV Criminal Justice Reform Mentoring/ Supportive Services for Youth High Risk Teams Housing Framework for Survivors of Violence and Abuse Immigration Laws/Meeting Needs of Undocumented Mental Health and Wellness Polyvictimization Self-Care and Wellness Specialized Programming and Initiatives in Family Justice Centers Select the topic(s) covered in your proposalPresentation Title(Required) Presentation Abstract(Required)It should include the purpose, main points, findings, and conclusion in a succinct, single paragraph.Learning Objectives(Required) Add RemoveProvide three objectives that describe measurable, observable outcomes that focus on the learner.References(Required) Add RemoveProvide three references for your presentation summary linking the presentation to current research or subject matter. References must be recent.Audience Level(Required) Beginner Intermediate Advanced One Page Summary(Required)Accepted file types: pdf, docx, Max. file size: 50 MB.Please provide a 300-600 word one-page summary that details more extensively research/practices/issues you will be discussing in your presentation. Δ
