YOUR CONTACT INFORMATION
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Are you a speaker for this workshop?*
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If you answered yes, what are your qualifications?
PROPOSED WORKSHOP INFORMATION
Title*
Length of Workshop (select which would best fit)*
45 minute plenary 1 hour 1 hour 30 minute 3 hours
Please select the category in which your workshop fits*
Building Skills Learning the Issues Public Policy Reaching Out Student Summit Does not fit in any of these categories
Provide a brief but specific description of the workshop (4000 characters or less)*
What action items will attendees leave your workshop with?*
Has this workshop been presented before?*
Yes No
If yes, when and where?
PROPOSED SPEAKER INFORMATION
Please submit information below for all proposed speakers if applicable, other than yourself.
Speaker #1
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Mr Ms Mrs Dr
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Title, if applicable
Address Line 1
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Qualifications
Speaker #2
Prefix
Mr Ms Mrs Dr
First Name
Last Name
Organization, if applicable
Title, if applicable
Address Line 1
Address Line 2
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State
Zip/Postal Code
Country
Phone Number
Email Address
Qualifications
Speaker #3
Prefix
Mr Ms Mrs Dr
First Name
Last Name
Organization, if applicable
Title, if applicable
Address Line 1
Address Line 2
City
State
Zip/Postal Code
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Phone Number
Email Address
Qualifications