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Civic Engagement, Leadership, & Service

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Gulf-South Summit on Service Learning, 2012OLD

Proposal Submission Form

Primary Presenter:

Mailing Address

Institution/Organization

Position or Title

State

City

Zip Code

Primary Contact:

Your E-Mail Address (Required)

Phone

FAX

Primary Presenter Bio

100 words maximum, including service learning or related experience

Co-Presenter 1

Name

Title

Institution

Co-Presenter 2

Name

Title

Institution

Co-Presenter 3

Name

Title

Institution

Co-Presenter 4

Name

Title

Institution

Presentation Format

Please select one

Individual Presentation
Panel Discussion
Interactive Workshop
Poster

Conference Track

Check all that apply

Transforming lives

Collaboration

Community

Citizenship

Level of Intended Audience

Introductory
Experienced
Both

Audiovisual Needs

Check all that apply

LCD Projector

Flip Chart

Overhead projector

Laptop

DVD Player

Internet Access

Title of Session

As it will appear on the conference program

Program Abstract

75 words maximum, as it will appear in the conference program. Abstract must accurately describe the presentation.

Program Description

500 words maximum. Provide rationale for the topic, goals for the presentation/workshop and ways in which participants will be engaged

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Gulf-South Summit on Service Learning, 2012OLD

Proposal Submission Form

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