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Community Sharing for Healthy Caring

2010 Workshop Proposal

Contact Name:
Job Title:
Business / Agency:
Email Address:
Address:
City:
State:
Zip:
Work Phone:
Home Phone:

Proposed Workshop

Your Creative Workshop Title:
Presenter 1:
Presenter 1 Job Title:
Presenter 2:
Presenter 2 Job Title:
Presenter 3:
Presenter 3 Job Title:
Mailing Address for Additional Presenters
Workshop Description	40 word or less description of your workshop content for the conference brochure

Please answer the following questions

1.) Type of Presentation: Lecture Make and Take Other

2.) Are you willing to present your workshop twice? Present Twice Yes Present Twice No

3.) I would be willing to present to a lrage group (approximately 100). Large Group Yes Large Group No

4.) Target area (Please choose one:)
Advocacy    Business    Child Care
Child Development    Infant/Toddler    Medical
Parenting    Prevention    School-Age

5.) Workshops are 80 minutes, but some extended (160 minutes) workshops can be offered.
How long will it take to cover your subject?
80 Minutes 160 Minutes

6.) Audio-Visual support needed:
None DVD TV/VCR Slide Projector Overhead Projector Power Point Projector Other

Workshop proposal deadline: Friday, June 4th, 2010

Notification of workshop selection will be mailed in August. For further information please phone 517-548-9112 or email CSHCconference@aol.com.