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Speaker Submission Form
Please read the list of
frequently asked questions
before completing this form.
Required Field: *
Contact Information
*
First Name
*
Last Name
*
Address
*
City
*
State
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
*
Zip
Phone Number
*
(Cell)
*
(Work)
Fax
*
E-mail
*
Do you have any health conditions or special religious considerations?
Yes
No
If yes, please explain.
Affiliation
School/Company Name
City
State
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
Presentation Experience
Please specify up to three recent presentations that are comparable to the Pre-Service Teacher Conference in regards to size, content, and/or audience. Please include their topics, locations, dates, and a contact for each presentation.
First
Topic
Location
Date
Contact
Second
Topic
Location
Date
Contact
Third
Topic
Location
Date
Contact
*
Target Audience
Please select the grade range(s) that your topic best applies to.
Elementary
Middle School
High School
University Students
Higher Education Faculty
*
National Standards
Please select the area that best fits your presentation.
Mathematics
Engineering
Science
Technology
Integrated Math, Science and Technology
Other/General Interest
Please describe how your presentation fits with national standards for education. Here are some sites to reference the standards for Math, Science and Technology.
Standards for Math
Standards for Science
Standards for Technology
*
Title of Presentation
Maximum of 75 characters.
*
Presentation Objectives
Enter the goals of your presentation and describe what you hope the attendees will gain from their participation.
*
Presentation Description
Enter the description of your presentation. Upon acceptance of your proposal, this description will appear on the website and in the Program Book. Limit of 1,000 characters.
*
Presentation Requirements
Please select any A/V equipment that you might need.
Notes:
Speakers must provide their own laptops.
Screens will be provided in the ballroom.
Ballroom does
not
have internet access.
No equipment required
Overhead Projector and Screen
LCD Projector (PC)
LCD Projector (Mac)
For any special equipment arrangements, please e-mail Sean O'Riley at
soriley@umes.edu
.
Pre-Service Teacher Conference
Pre-Service Teacher Institute
Pre-Service Teacher Program
Dr. Paula Tucker-Hogan
PSTP Director
National Institute of Aerospace
(757) 325-6915
Dr. Patricia Carter
Program Manager
University of Maryland
Eastern Shore
(410) 621-3383
Gretchen Boggs
Conference Coordinator
(302) 524-1099
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