Lead Presenter: (required) Dr.Mr.Mrs.Ms.None First Name Last Name Job/Position Title: (required) Office/Department: (required) Name of Institution/Organization: (required) Are you a Vendor? YesNo Address (Business or Personal): (required) Street: City: State: Zip Code: Email: (required) Phone How many Co-Presenters do you have? 012
Do you have additional presenters? NoYes
Topic Focus: (Select One, required) CoachingTutoringCenter OperationsOther Title: (75 Charecters or Less, required)
Summary: In 150 words or less, please provide a description of your 50 minute presentation. If accepted, this will be used in the conference brochure. (required)
Audience Take-Aways/Learning Outcomes: In 50 words or less, describe 2-5 learning outcomes that the audience will take away from your session. (required)
Additional Comments: Use this space to provide any additional information ACTP may need to know to select or support your presentation.