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Workshop Submission Form

Please read the list of frequently asked questions before completing this form.

Workshop submissions are due September 7, 2007.

Required Fields: *

Contact Information
* First Name
* Last Name
* Address

* City
* State
* 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
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.


* National Standards
Please select the area that best fits your presentation.

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 150 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.

What kinds of materials will participants take home?

Will you have your presentation or other materials available on a website for participants to download? If so, where?


* Workshop Requirements
Please enter your maximum workshop capacity.


Please select your workshop duration.


Please select your seating arrangement.


Please select any A/V equipment that you might need. Notes: 1. Presenters must provide their own laptops and LCD projectors. 2. LCD Support Package includes all necessary power and video cables, table, and screen needed to use an LCD Projector. Select this option if you will be bringing your own projector so that you will be put in a room with a screen. 3. Meeting rooms do not have internet access.

For any special equipment or seating arrangements, please e-mail Sean O'Riley at soriley@umes.edu.

*Additional Workshop Availability
Would you be willing to do an additional workshop if needed?
Yes
No
Co-Presenter Information
If you will have anyone helping you present your workshop, please enter their name below.
Co-Presenter Name(s)
1.
2.




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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NASA Official: R. Hathaway, Head of the Office of Education
Last Updated: September 21, 2007
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