2026 MMMHS Call for Proposals

Primary Presenter Name:

First NameLast Name

Email:

example@example.com

Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number:

Please enter a valid phone number.Format: (000) 000-0000.

Education: (Degrees/Major)Additional Credentials (Certifications / Licensure)

Name of Agency/Organization: Example: ABC Counseling Services, LLC.

Current Role Position: (How you want it published ex. Professor, Educator, Agency Director, ect.)

Please upload your professional short bio: (How you want it published)

Please upload your professional RESUME: (NOTE: No more than 5 pages, NO CV's PLEASE)

Proposed Workshop Title: Please ensure the title describes the content as the title and your name / credentials will be provided in the registration materials.

Session Category: Please select the category of your session content.

Please provide a description of your session - 300 words or less.

Please list at least 3 specific learning objectives. Session objectives will be listed on the website to assist attendees with session options the day of the conference. Format: Participants will ...

Length of Session: Please indicate the preferred length of the session.

Session Repeat: If needed, are you willing and / or able to repeat your session?

Name

First NameLast Name

Email

example@example.com

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Name of Agency/Organization Example: ABC Counseling Services, LLC.

Current Role Position (How you want it published ex. Professor, Educator, Agency Director, ect.)

Please upload your professional RESUME (NOTE: No more than 5 pages, NO CV's PLEASE)

Please upload your professional short bio (How you want it published)

Proposed Workshop Title: Please ensure the title describes the content as the title and your name / credentials will be provided in the registration materials.

Session Category: Please select the category of your session content.

Length of Session: Please indicate the preferred length of the session.

Session Repeat: If needed, are you willing and / or able to repeat your session?

Presenter Terms and Conditions:

In submitting a proposal, I understand that I am agreeing to the following on behalf of all individuals participating in this presentation:

• Presenter(s) must be available to participate in the conference at the time scheduled by the conference committee.

• All travel-related costs, including meals not included with the conference, lodging and airfare, are the responsibility of presenter(s). The MMMH Symposium is an in-person event. The PRIMARY presenter (only) will receive an honorarium.

• Agreement to participate in the conference and grants permission for the presentation to be recorded (audio and/or video), photographed, and used in social media and other conference related summaries and promotion.

Submissions:

Submit this form electronically by June 19, 2026 at 11:59 CST

Communication:

The primary presenter will be the individual with whom symposium staff will contact, ask questions, and notify of dates and times of scheduled session(s).

The primary presenter is considered the individual who is responsible for signing the presenter agreement included within the workshop proposal form.

The primary presenter will be notified by email of the decision by July 1, 2026.

It is the responsibility of the primary presenter to share information and details about the proposal status with co-presenters.

Should you have any questions about the workshop proposal submission process, please contact the planning committee at msminoritymentalhealth@gmail.com

We thank you for taking time to submit your workshop session proposal.

Signature

Mississippi Minority Mental Health Symposium 2026 Call for Proposals

Primary Presenter Information

Additional Presenter Information (if applicable)

Presenter Agreement