CTD Proposal Submission Form

2022 Connecting the Dots workshop Proposal sumbission form

* Indicates required field

Title of Presentation *

Please list two or three learning objectives for the session.

Objective #1 *

Objective #2 *

Objective #3 *

Format of Session *

Intensive (3-4 hours) Workshop (75 minutes)

Session Topic *

Presentation Description (75 words or less) *

Presenter #1 *

First

Last

Presenter #1 Photo *

Max file size: 20MB

Brief Bio - Presenter #1 *

Email *

Phone Number *

Agency Address *

Line 1

Line 2

City

State

Zip Code

Country

Presenter #2 *

First

Last

Presenter #2 Photo *

Max file size: 20MB

Brief Bio - Presenter #2 *

There is a big screen television with HDMI connection in each breakout room. You will need to being your own laptop that is HDMI compatible. If you are unable to provide your own equipment, please describe you requirements.

Equipment Requirements *

Submit