Roundtable Proposal Form

Roundtable Proposal Form
Facilitator Information
Please provide the following information as you would like it to appear in the 2009 conference program if your proposal is accepted.
First Name:
Last Name:
Title/Position:
College/Organization:
Address:
City, State, Zip	,
Phone:	(no dashes - 3032693798)
Fax:	(no dashes - 3032693798)
E-mail:
Note to all prospective presenters: The same information will be shared a total of 6 times for 15 minutes each time. Any materials should be designed for participants to "grab-and-go" and then apply in their own classroom. Title and Brief Description: Give us a 1 - 2 sentence description of what participants will experience at your table. Examples: An Art Discovery Moment - After you've left this table, you will have a colorful representation of your inner self .... and a little fun along the way. Who's Who? - Experience a variety of activities to introduce participants or class members in any group setting. Find a way to go beyond, "Tell us your name and what you do."
Roundtable Title:
Description:	maximum 30 words: to be printed in program if proposal is accepted.
Additional Comments:
Proposals must be submitted by November 9, 2008. Facilitators will be notified by December 10, 2008. Neither honoraria nor expenses will be paid.
If you do not use the form provided above, please send a hard copy of your completed proposal to: Teaching for a Change, P.O. Box 404, Howe, TX 75459, fax - 903.532.1619, info@teachingforachange.com