A national conference focusing on the literacy needs of individuals with visual impairments
Please fill in the form below and submit no later than May 20, 2011. You will be notified within two months of that date with the status of your proposal
After submitting the form, you'll see a page display with your information. Please print that page for your records.
Suffix Select... Mr. Mrs. Ms. Dr.
First Name
Last Name
Title
Affiliation
Address 1
Address 2
City
State
Zip
Day Phone
Evening Phone
Email
Presentation Type Select... Workshop Poster Session
Title of Workshop or Poster Session
Additional Workshop Presenters’ Names, Titles, and Affiliation (complete only if applicable). YOU MUST HAVE ALL PRESENTERS LISTED HERE TO BE INCLUDED IN THE CONFERENCE PROGRAM. Write names, titles and affiliation exactly as you want them to appear in the program.
Please select the primary strand that BEST applies to your workshop
Primary Strand Select... Emergent Literacy Educational Instruction and Assessment Functional Literacy Vocational/Adult Literacy Assistive Technology and Tactile Graphics
If you feel your proposal applies to more than one strand, please select the appropriate secondary strand.
Secondary Strand Select... Emergent Literacy Educational Instruction and Assessment Functional Literacy Vocational/Adult Literacy Assistive Technology and Tactile Graphics
Description of workshop or poster session for registration packet (<100 words)—please be specific and include:
Please list up to three learning objectives which participants will gain through your workshop or poster session. These objectives will provide necessary information for obtaining continuing education credits for conference attendees.
1.
2.
3.
All rooms will be equipped with the following equipment:
If you need the following items, please come prepared with your own equipment:
If you have additional AV needs , please specify your needs below.
If you would like to speak with someone regarding special requests, please contact Janie Blome.
Thank you for your submission. After submitting the form, you'll see a page display with your information. Please print that page for your records.
If you are unable to submit electronically, please call Janie at 502-899-2367.