ONLINE WORKSHOP PROPOSAL FORM

INVITATION TO ENCOUNTER:
MEET ME IN ST. LOUIS

67^th Annual ASGPP Meeting
March 26 - 30, 2009
St. Louis, Missouri

CALL FOR PAPERS/WORKSHOP PROPOSAL FORM

Proposals must be submitted through the online system via the ASGPP web site. Proposals sent by email, fax or any other form will not be accepted.

Online proposals must be received by June 30, 2008. You will be notified regarding the disposition of your proposal in August, 2008. If your proposal is included in the conference, you will be required to submit a non-refundable fee of $100 along with your acceptance, to be credited toward your registration. This fee will not be refunded if you cancel your registration.

TITLE OF THE PROPOSED PRESENTATION: (50 CHARACTERS Maximum)

ABSTRACT: (50 -75 Words) Briefly describe the purpose of your presentation, the theme it addresses, the main learning objectives, the method of presentation: lecture, didactic, demonstration, experiential, discussion.
Be CLEAR and SUCCINCT. Describe what the participants at your presentation/workshop should be able to learn.

NAME, CREDENTIALS, AND INSTITUTIONAL AFFLIATION OF PRINCIPAL PRESENTER - FOLLOWED BY NAME, CREDENTIALS, AND INSTITUTIONAL AFFLIATION OF ALL CO-PRESENTERS (for inclusion in the program):

BIOGRAPHICAL STATEMENTS: (NO MORE THAN 25 WORDS)

A. Principal Presenter:

B. Co-Presenter:

TYPE OF PRESENTATION(check all that apply)

1 Day Pre or Post Conference Training Institute 90 minute Mini-Workshop 60 minute “Conversation Hour”
½ Day Pre or Post Conference Training Institute 90 minute Paper/Discussion 25 minute Potpourri Session
2 ½ hour workshop 90 minute 2 ½ hour Panel Discussion Special Interest Group Meeting
Master Class for TEPs, PATs, CPs

What percentage of your presentation is: % experiential % didactic % discussion

Maximum Group Size PLEASE SPECIFY MAXIMUM NUMBER

How would you characterize this presentation? Introductory Intermediate Advanced All levels Master Class (TEP,PAT,CP)

Who is the target audience? Students Practitioners Trainers Further Specifications

Room Format and Materials: Stereos, tape decks, CD players, slide projectors, overhead projectors, VHS VCR monitors and computers must be arranged and paid for by the presenter. (Contact the National office for details.) chairs in a horseshoe without a table an empty room chairs in a horseshoe with a table flip chart / markers theater style other (specify)

Principal Presenter: type in (or paste) a Resume or Curricula Vitae (NO LONGER THAN FOUR PAGES, OR LAST TEN YEARS, WHICHEVER IS SHORTER)

Name (first and last) Degree(s) _
Title and Institutional Affiliation (for inclusion in program)

Mailing Address:
City: State: Zip:
Phone: (home) (business) FAX: E-mail:
Other licenses and/or certifications:
ASGPP Status: Student Member Member Fellow Honorary Member Non-Member

Psychodrama Certification: TEP
PAT in training with
CP
in Training for CP with
Have you presented at previous ASGPP meetings: Yes National Local
Have you presented at other professional meetings: Yes No
If yes, when was the last time you presented?
Name of the professional meeting/group to which you presented?
Title of Presentation:
References:

Co-Presenter: type in (or paste) a biographical statement (no more than 25 words) at the bottom of this page, to be used in conference material.
Please include Curricula vitae:

Name (first and last) Degree(s) _
Title and Institutional Affiliation (for inclusion in program)

Mailing Address:
City: State: Zip:
Phone: (home) (business) FAX: E-mail:
Other licenses and/or certifications:
ASGPP Status: Student Member Member Fellow Honorary Member Non-Member
Psychodrama Certification: TEP PAT in training with
CP in Training for CP with
Have you presented at previous ASGPP meetings: Yes National Local
Have you presented at other professional meetings: Yes No
If yes, when was the last time you presented?
Name of the professional meeting/group to which you presented?
Title of Presentation:
References: