Center on Disabilities,
"Technology and Persons with Disabilities" Conference ~ March 20-25, 2006
PROPOSAL FORM FOR GENERAL SESSIONS
Submit proposal no later than October 1, 2005

Please read the Proposal Form Guidelines BEFORE filling in this form

SECTION A

1. PRESENTER(S) INFORMATION
If there are more than two presenters, please provide all their contact information at the end of this document. Please list only the names of those who are actually attending the conference. DO NOT list authors who are not attending the conference.

Presenter #1

First Name: *
Last Name: *
Organization: *
Street Address: *
City: *
State/Province/Region: *
Zip/Postal Code: *
Country: *
Day Phone: *
Fax:
Email: *

Presenter #2

First Name:
Last Name:
Organization:
Street Address:
City:
State/Province/Region:
Zip/Postal Code:
Country:
Day Phone:
Fax:
Email:

The Center on Disabilities provides contact data (names and mailing addresses) to third parties who wish to promote relevant products, services and other opportunities which may be of interest to you. If you do not want your contact information made available to third parties for marketing purposes, please check here.

2. TITLE OF PAPER: *
Limit the title to 12 words or less. (Longer title will be edited.) The title of the paper must be concise and descriptive. It must accurately describe the content of the paper.

3. 1-2 SENTENCE SUMMARY: *
It is vital that the 25-word description reflect the content of the presentation. Summaries should include the basic content of the proposed session, the method for information delivery, and the source of the information. This summary will be printed in the conference program. Please note, summaries may be edited for length at the discretion of the conference organizers.

4. COMPLETE PAPER:
Submit an electronic copy of the complete paper with this proposal form. See Proposal Form Guidlines, Section A, item 4.

Send by email to: conference@csun.edu or copy onto diskette and mail with proposal form to:
Call For Papers, Center on Disabilities
California State University, Northridge
18111 Nordoff Street
Northridge, CA 91330-8340

SECTION B

5. LENGTH OF SESSION (Choose desired time block from the 4 options available) *
30 minutes
60 minutes
Extended (for computer lab sessions only) List desired length:
No preference

6. TOPIC (choose ONE topic that best fits your proposal) *
AAC
Aging and Disability
Assessment and Service Delivery
Blind/Low Vision
Cognitive Disabilities
Deaf and Hard of Hearing
Employment
Internet/WWW
K-12
Learning Disabilities
Legal Issues
Postsecondary
Psychiatric Disabilities
Other

7. STYLE (choose ONE of the seven styles that is most descriptive to your proposal) *
Lecture
Panel Discussion
Demonstration
Hands-on
Computer Lab using Mac's
Computer Lab using PC's

8. VENDOR (chose if you are a vendor or not) *
Yes      No

9. LEVEL (choose ONE of the three levels that best meets the typical audience) *
Beginner
Intermediate
Advanced

10. MAJOR DISABILITY GROUP (check all that apply) *
Behavioral/Emotional Disorders
Deaf/Blind
Deaf and Hard of Hearing
Developmentally Disabled
Learning Disabled
Mobility/Physical/Orthopedic
Speech/Language
Traumatic Brain Injury
Visual Disability
All

11. EQUIPMENT *
Note: All session rooms are set theater style (chairs only), and are equipped with a projection screen, a SGA/LCD color projection unit, one lavaliere microphone, and one hand held microphone. Please check equipment you are requesting for your presentation:
None
Windows based PC
Apple based PC
Internet Access (limited availability)
DVD Player
VCR (NTSC Format)
Easel, Pad, & Markers
Other (Type selections in space below)

*Other equipment subject to availability. You will be notified by the Center if the equipment you are requesting is not available.

It is expressly understood that any equipment not checked off is the responsibility of the presenter.

SECTION C

12. SIGN AND DATE
I/We agree to the Conditions of Presentation and have included an electronic copy of the complete proceedings paper.

Signature: (typed name accepted as signature) * Date: *
Email Address: *

13. SENDING PROPOSAL FORM AND COMPLETE PAPER

Email: conference@csun.edu

Fax: 818/ 677-4929 (send an electronic copy of complete paper either on disk or email)

Mail: Call For Papers, Center on Disabilities
California State University, Northridge
18111 Nordoff Street
Northridge, CA 91330-8340

 

For additional presenters please continue. Or you may submit your proposal now.

ADDITIONAL PRESENTERS (If needed)

Presenter #3

First Name:
Last Name:
Organization:
Street Address:
City:
State/Province/Region:
Zip/Postal Code:
Country:
Day Phone:
Fax:
Email:

Presenter #4

First Name:
Last Name:
Organization:
Street Address:
City:
State/Province/Region:
Zip/Postal Code:
Country:
Day Phone:
Fax:
Email:

Presenter #5

First Name:
Last Name:
Organization:
Street Address:
City:
State/Province/Region:
Zip/Postal Code:
Country:
Day Phone:
Fax:
Email:

* Required Fields