Education Leaders Fall Conference Call for Professional Presentations
Education Leaders Fall Conference Small Group Session Proposal Form Springfield, IL - October 16 - 18, 2016
RPrimary Speaker Name:
RJob Title:
RSchool/Organization:
RAddress:
RCity:
RState:
RZip:
RPhone:
RE-mail:

RIPA Member?
RMy organization is best described as (please check all that apply):
RCurrent enrollment:
ADDITIONAL SPEAKERS: (Correspondence will only be sent to the Primary Speaker listed above.)
Name:
Title:
School/Organization and City:
Email Address
IPA Member?
Name:
Title:
School/Organization and City:
Email Address
IPA Member?
(If there are more than two additional speakers, please attach another typed sheet with information.)

SESSION FACILITATOR: (Facilitators introduce the speaker and distribute evaluation forms.)
Facilitator Name:
Title:
School/Organization:
School Address:
City:
State:
Zip:
(IPA will select a facilitator for you if none is listed.)

RLeadership Competencies (Please check all that apply)
RSchool level for which your program is appropriate:
RProgram Title:
Learning Objectives of Session: ("At the end of my session, participants will be able to ...")
1.
2.
3.
RProgram Abstract 1. Are you focused on an outcome or a process? Please explain.
R2. Description of Session: Provide a one paragraph description of the presentation. This description will be used as criteria to judge.
R3. What skills or insights will your audience develop or be enhanced by attending your session?
R4. We strongly suggest you have handouts to share with your audience. Please describe what you will have. (Plan on 75 attendees per session)
R5. Have you made this presentation before?
If yes, where/when?
R6. Basic audio visual equipment will be provided upon request. Please indicate what you need for your presentation.
R7. Please submit a 75 word or less vita for the moderator to introduce you.
R8. Please provide a 100 word description of your presentation. If your presentation is accepted, this description will be printed in the conference agenda.