2012 IN ED Conference Proposal Form

30th Annual Indiana Annual Conference on Emotional Disabilities
From Pearls of Wisdom to Gems for the Future

The Indiana ED Conference seeks to improve services for students with Emotional Disorders by providing innovative, practical strategies for anyone who works with students who present challenging behaviors. The theme for the 2012 conference is From Pearls of Wisdom to Gems for the Future. We are seeking a wide variety of presentations surrounding this theme from practitioners, administrators, researchers, trainers, advocates, parents, students and others who work in or with education, mental health, juvenile justice or related fields.

You are invited to participate in the program of this conference as a presenter. Our priority is to provide content that focuses on innovative and best practices that demonstrate effective evidence-based strategies designed to meet the needs of students. This is an excellent opportunity to present and showcase your work to general and special education teachers, administrators, teacher trainers, alternative school personnel, and others who provide direct or indirect services to children and youth.

Presentation Proposal Form

DEADLINE FOR SUBMISSIONS: March 1, 2012 (submit early for early acceptance)

NOTIFICATION OF ACCEPTANCE: ongoing through March 12, 2012

Please Note:

Multiple proposals are invited, however, please submit one online form per proposal.

All presenters and co-presenters must register for the conference. Due to budgetary considerations, it is not possible to offer either an honorarium or a waiver of registration fees to program presenters. However, presenters are offered a discounted registration rate. Your proposal is an acknowledgement of this requirement.

The principal presenter is responsible for keeping all co-presenters informed of all correspondence from BICA and the conference planning committee.

Presenters are solely responsible for the information presented. Acceptance of a proposal does not imply that the content represents an official position, endorsement or support by BICA, its employees or Board of Directors.

Please type your initials to electronically indicate that you have read and agree to the above-noted requirements:

Please provide the following PRINCIPAL PRESENTER contact information:

First Name

Last Name

Middle Initial

Organization

Address Type Home Work

Street Address

Address (cont.)

City

State/Province

Zip/Postal Code

Country

Work Phone

(format xxx-xxx-xxxx)

Home Phone

(format xxx-xxx-xxxx)

FAX
(format xxx-xxx-xxxx)

E-mail

Confirm E-mail:

CO-PRESENTER 1 contact information (if applicable):

First Name

Last Name

Middle Initial

Organization

Address Type Home Work

Street Address

Address (cont.)

City

State/Province

Zip/Postal Code

Country

Work Phone

(format xxx-xxx-xxxx)

Home Phone

(format xxx-xxx-xxxx)

FAX
(format xxx-xxx-xxxx)

E-mail

CO-PRESENTER 2 contact information (if applicable):

First Name

Last Name

Middle Initial

Organization

Address Type Home Work

Street Address

Address (cont.)

City

State/Province

Zip/Postal Code

Country

Work Phone

(format xxx-xxx-xxxx)

Home Phone

(format xxx-xxx-xxxx)

FAX
(format xxx-xxx-xxxx)

E-mail

ADDITIONAL C0-PRESENTERS:

If you have more than three presenters, please use this space to type in their names and addresses (if addresses are the same as other presenters, you may just indicate so).

PREFERRED PRESENTATION TYPE:

	Workshop (120 minutes)
	Breakout Session (60 minutes)
	Poster Sessions & Program Sharing Sessions

Please indicate if there are any times you are UNABLE to present:

Thursday

Friday

Please use this space to make any notes regarding your presentation preferences and availability:

PRESENTATION TITLE:

BRIEF DESCRIPTION FOR PROGRAM:

Please provide a brief (approximately 60-word) description for the conference program. In your description, please indicate your intended audience (i.e., early childhood, elementary, middle school, secondary, higher ed, all) and level of the material you will present (i.e., introductory, intermediate, advanced, all levels).

TOPIC:

Please select the ONE that best fits

Autism Spectrum Disorders

Bullying, Aggression and Safe Schools

Classroom Management/PBIS

Collaboration and Co-teaching

Dropout Prevention and Preparing for Adult Life (Transition)

Early Intervention

Ethics, Law and Legal Issues

Juvenile Justice

Mental Health Issues and Services

Professional Development

Program Sharing (Special poster session opportunity)

Research: Current and Future Directions

Social Emotional Learning

Services in Alternative/Special Schools

Teaching Core Academics

Other: Please specify:

LEARNING OUTCOMES:

Please provide a bulleted list of what participants will learn from this session.

Note: certain CEU providers require specific learning objectives.

PROPOSAL:

What is the purpose of the presentation (why is this important and who is the target audience)? What are you planning to do? What are the practical applications (how can your results/strategies be used by others)? How does this presentation address research-based standards? Please type or cut and paste (up to 500 words)

EQUIPMENT NEEDS:

Notes:

A screen will be set up in each presentation room and rooms will be set theater-style.

You are welcome to bring your own equipment, however BICA will not be responsible for any personal equipment used for presentations.

BICA cannot provide laptop computers.

Please check all that apply:

Overhead Projector

LCD Projector (DVDs should be run off computers through LCD Projectors)

Flip Chart

Other:

SPECIAL NEEDS: Please indicate if you have any special needs or requests.

THANK YOU!