2017 AMPO Annual Conference – Call for Presentations Submission Form

Upon completion of this form, please email it to Bill Keyrouze at bkeyrouze@ampo.org AND Rachel Roper at rroper@ampo.org by April 14th, 2017.

NAME(s):

NAME OF PRESENTER(s) (if different than above):

PRESENTER(s’) BRIEF BIO(S) (75 words or less):

ORGANIZATION(s):

PHONE(s):	EMAIL(s):

TOPIC/SUBTOPIC AREA(s):

PRESENTATION TITLE:

ESTIMATED LENGTH OF PRESENTATION (Please note: most submissions will be considered for 20-minute presentation slots. If selected, it will be included as part of a panel comprised of various proposals.):

SUMMARY OF PROPOSAL (This is intended to give a brief overview of your proposal. Please limit your summary to 2-3 sentences.):

SPECIAL NOTES (Please list any special considerations or notes to the reviewers.):

FULL DESCRIPTION OF PRESENTATION IDEA (Please limit your description to 1,000 words.):