"Technology and Persons with Disabilities" ~ 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 on a separate sheet. 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:	
Address:
City: 	
State/Province/Region:
Zip/Postal Code: 	
Day Phone:
Fax: 	
Email: 	

Presenter #2
First Name:	
Last Name:
Organization:	
Address:
City:	
State/Province/Region:
Zip/Postal Code: 	
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 Guidelines, 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 Nordhoff Street, Northridge, CA  91330-8340

SECTION B 

5. LENGTH OF SESSION (Choose desired time block)
__ 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 style most descriptive to your proposal)
__ Lecture
__ Panel Discussion 
__ Demonstration 
__ Hands-on 
__ Computer Lab using Mac's
__ Computer Lab using PC's 

8. VENDOR
__Yes
__ No

9. LEVEL (choose ONE level 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: 
__ Windows based PC
__ Apple based PC
__ Internet Access (limited availability)
__ DVD player
__ VCR (NTSC Format)
__ Easel, Pad, & Markers
__ *Other __________________________________________
*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:

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 Nordhoff Street, Northridge, CA  91330-8340