Please use this form to submit your request to be a presenter at the MTEC Winter Symposium. Please be sure to read the full instructions before submission.
Presentation Title
*
Lead Presenter Name
*
First Name
Last Name
Position
*
Educational Institution or Business Name
*
Names and Contact of Additional Presenters
*
Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Email
*
example@example.com
Phone Number
*
Session Title: The session title should be no more than 10 words and should be included on both the cover sheet and proposal itself so the proposal can be matched with the cover sheet at the conclusion of the blind review.
*
Presentation Format
*
Workshop session
Roundtable discussion
Special session designed for interns/residents or pre-service
Description/Purpose: In approximately 250 words or less, clearly describe the purpose of your presentation, list at least three goals you hope to accomplish by the end of your presentation and describe in detail how you will meet the goals. This information will be used by the committee for reviewing and selecting proposals
*
0/250
Summary: Provide a brief summary (no more than 50 words) that can be copied and pasted directly into the program. This summary will guide attendees in symposium selections.
*
0/50
Target Audience: Indicate who the target audience is for your session (check all that apply).
*
PK-3 Teachers
3-5 Teachers
6-8 Teachers
9-12 Teachers
Administrators
Pre-service Teachers
Interventionists
Interns/Pre-service Teachers
Other
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