Workshop Proposal Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form. - Step 1 of 2Primary Presenter InformationYou will have the ability to enter additional presenters if needed.Name *FirstLastPlease add the name of the lead presenter.Email *EmailConfirm EmailPhone *Title and/or credentials *e.g. Director, MSW, etc.Company or Organization's Name *Address *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeBrief Biography *Please add a brief biography to be included in the conference app.Speaker Photo Upload * Click or drag a file to this area to upload. Please upload a photo of the speaker to be included in the conference app.Will there be any additional speakers? *Select Yes or NoYesNoAdditional Speaker InformationAdditional Speaker's Name *FirstLastPlease add the name of the second speaker.Additional Speaker's Email *EmailConfirm EmailAdditional Speaker's Phone *Additional Speaker's Title and/or Credentials *e.g. Director, MSW, etc.Additional Speaker's Company or Organization's Name *Additional Speaker's Brief Biography *Please add a brief biography to be included in the conference app.Additional Speaker's Photo Upload * Click or drag a file to this area to upload. Please upload a photo of the speaker to be included in the conference app.Will there be any additional speakers? *Select Yes or NoYesNoAdditional Speaker InformationAdditional Speaker's Name *FirstLastPlease add the name of the third speaker.Additional Speaker's Email *EmailConfirm EmailAdditional Speaker's Phone *Additional Speaker's Title and/or Credentials *e.g. Director, MSW, etc.Additional Speaker's Company or Organization's Name *Additional Speaker's Brief Biography *Please add a brief biography to be included in the conference app.Additional Speaker's Photo Upload * Click or drag a file to this area to upload. Please upload a photo of the speaker to be included in the conference app.Will there be any additional speakers? *Select Yes or NoYesNoIf there are more than three, you will have the opportunity to add additional presenters once your submission is approved. Please add total number of presenters below. *NextPresentation InformationPlease take the time to submit a clear and thoughtful proposal. Utilize grammar and spell-check tools to enhance readability and understanding. If selected, the information submitted will be utilized in the Conference App and in promotional advertising.Presentation/Workshop Title *Short Description *Long Description *Learning Objectives *Please include a minimum of three learning objectives stating what attendees should know, understand, or be able to do by the end of the session.Select the track that best fits. *Healthy AgingCommunity ConnectionsProfessional DevelopmentSocial Support & InclusionLivability, Mobility, & AccessibilityPlease see longer descriptions above.Presentation Type *LectureRound-table DiscussionGroup WorkCase PresentationSkill Application (Role Playing, Interactive Work, etc)OtherPlease select the presentation type that best fits.Please specify:Who is your target audience? *NoviceExperiencedSocial WorkerDirectors/Assistant DirectorsActivity/Program CoordinatorTransportation/Mobility CoordinatorBoard MemberOutreach Worker/CoordinatorVolunteer CoordinatorOtherSelect all that apply.Please specify: Would you like your session to be submitted for CEUs through NASW? *Select Yes or NoYesNoPlease include at least three bibliographical references for the content. *This is an NASW requirement. If not completed, the session will not be submitted for CEU consideration.Please describe how the content applies to clinical and/or macro social work practice. *This is an NASW requirement. If not completed, the session will not be submitted for CEU consideration.Have you presented for MCOA previously? *Select Yes or NoYesNoWill you have handouts? *Select Yes or NoYesNoWill you have any audio/visual needs other than a projector and screen? *I will not need a projector or screenYesNoPlease specify: *Please select your top three session times. *Wednesday, October 23rd 10:45am - 12:00pmWednesday, October 23rd 1:15pm - 2:30pmWednesday, October 23rd 3:00pm - 4:15pmThursday, October 24th 9:00am - 10:15amThursday, October 24th 10:45am - 12:00pmThursday, October 24th 3:00pm - 4:15pmFriday, October 25th 9:00am - 10:15amFriday, October 25th 10:30am - 11:45amAll sessions are 75 minutes. The Conference Committee will do their best to accommodate schedules, however it is not guaranteed.Additional InformationPlease share anything else that may be relevant.Would you be interested in presenting at other MCOA events?Select Yes or NoYesNoMCOA is dedicated to providing educational and training opportunities to the membership throughout the year. Please select yes if you would be interested in being contacted for future opportunities.Submit
