CYC Assets Presenter Form
Name of Presenter
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First Name
Last Name
Credentials
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Name of Co- Presenter (if applicable)
First Name
Last Name
Credentials of Co-Presenter
E-mail
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When would you like to deliver your webinar
Proposed Date of Webinar Delivery
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Month
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Day
Year
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Time of Webinar: Each webinar is 120 minutes (EST)
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Hour
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Minutes
AM
PM
AM/PM Option
Tell us about the webinar you would like to present.
Webinar Title
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Write a description of your webinar that can be used on the course.
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Domain of Practice
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Please Select
Professionalism
Cultural and Human Diversity
Applied Human Development
Relationship and Communication
Developmental Practice Methods
Knowledge Base Level For:
Novice - Participants are new to the field or this topic
Intermediate - Participants will have some skill or knowledge of this topic
Advanced - Participants already have a high level of skill, experience and knowledge of this topic
Describe the ideal attendee who will benefit most from attending your webinar. ie. front line, supervisors, school based, etc.
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Four Learning Outcomes
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Include a Knowledge Assessment Question that will align with each of the learning outcomes. (Multiple choice format) Please indicate correct answer. You can submit these with your slides if you prefer.
Your Biography (written in third person and 150 words max.
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0/150
Jpeg Photo of You
*
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Jpeg Photo of Co-Presenter if applicable
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