WCWC Request for Proposal 2024
Thank you for your interest in becoming a presenter for the Whole Child Whole Community Conference- www.wcwcconference.cissa.org. Submissions are due on June 28, 2024 and you will be notified of the selection committee's decision by July 17, 2024. If you are presenting with multiple presenters, please have only one presenter or panelist submit the request for proposal form for your group. You will need the following items and information for each presenter/panelist: headshot, resume/CV, email, phone number, short bio & front of the room experience. If you have any questions, please email Shelly Bosse: sbosse@cissa.org
How many presenters will be a part of your presentation?
*
1
2
3
Panel - 3 presenters, 1 moderator
Presenter #1
*
First Name
Last Name
Credentials, if any (LPC, LMSW, MA. etc...)
*
Organization
*
Email
*
example@example.com
Best Contact Number
*
Please enter a valid phone number.
Please upload your headshot here (note this will be added to the event website if you are selected):
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Please provide a short bio we can use for the WCWC website:
*
Please upload your CV/resume here:
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Please provide a brief summary of your front-of-the-room training experience:
*
Presenter #2
*
First Name
Last Name
Credentials, if any (LPC, LMSW, MA. etc...)
Organization
*
Email
*
example@example.com
Best Contact Number
*
Please enter a valid phone number.
Please upload your headshot here (note this will be added to the event website if you are selected):
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Please provide a short bio we can use for the WCWC website:
*
Please upload your CV/resume here:
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Please provide a brief summary of your front-of-the-room training experience:
*
Presenter #3
*
First Name
Last Name
Credentials, if any (LPC, LMSW, MA. etc...)
*
Organization
*
Email
*
example@example.com
Best Contact Number
*
Please enter a valid phone number.
Please upload your headshot here (note this will be added to the event website if you are selected):
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Please provide a short bio we can use for the WCWC website:
*
Please upload your CV/resume here:
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Please provide a brief summary of your front-of-the-room training experience:
*
Moderator
*
First Name
Last Name
Credentials, if any (LPC, LMSW, MA. etc...)
*
Organization
*
Email
*
example@example.com
Best Contact Number
*
Please enter a valid phone number.
Please upload your headshot here (note this will be added to the event website if you are selected):
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Please provide a short bio we can use for the WCWC website:
*
Please upload your CV/resume here:
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Please provide a brief summary of your front-of-the-room training experience:
*
Training Session Title
*
Description of session:
*
Learning Outcomes (list at least 3):
*
Focus Area (select all that apply):
*
Fostering Relationships To Unlock Student Potential
Promoting Mindfulness, Health and Positive Development
Inspiring Professional Collaborations
State of the Heart: Supporting Youth in Today's World
Target Audience (Select all that apply):
*
School Staff
General Community
Nonprofit Professional
Mental Health Provider
Other
CIS-SA's goal is that all conference participants will have an engaging learning experience. How do you plan to interact with your audience or build in opportunities for dialogue?
*
Participant Materials Needed (paper, pen, comfortable clothing, any items to be purchased by CIS-SA, etc...):
Please indicate any questions or comments you have.
Please add any additional documents here:
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Save
Submit
Should be Empty: