NAKPEHE
PROPOSAL SUBMISSION FORM


The NAKPEHE National Conference

Hotel Albuquerque at Old Town, Albuquerque, New Mexico
January 2-6, 2008

Deadline for proposal submission: October 1, 2007
What is your first name?
What is your last name?
E-mail Address

To propose a program for the 2007 NAKPEHE Conference, provide the following information.

1. Title of proposed program:

2. For consideration submit a 500 word summary of your proposed program:

3. Speaker Name:
Street Address:
City: State Zip
School/Business Affiliation:
Work City: State Work Zip
Phone (W): Phone (H): Phone (Fax):

3a. Additional Speaker Name:
3aa. Additional Speaker Affiliation:

3b. Additional Speaker Name:
3bb. Additional Speaker Affiliation:

3c. Additional Speaker Name:
3cc. Additional Speaker Affiliation:

Please note: Only speakers who register for the conference will be cited in the Conference Program.

4a Will you be bringing a computer for your presentation?
Yes No

4b Will you be bringing an LCD projector for your presentation?
Yes No

5. If yes, are you willing to permit others to use your equipment?
Yes No

6. Do you prefer
Traditional presentation Poster No preference

Please note that it is possible that your presentation format may be changed to meet conference needs.

7. This proposal is intended for:
Regular conference session Administrative session

Please note that it is possible that your presentation may be changed to meet conference session needs.
Any changes to your NAKPEHE CONFERENCE proposal should be addressed to [email protected]. Questions? 361-698-1338.

Secure HTML form processor