LEAD PRESENTER* (Last, First, Middle Initial):

POSITION:    EMPLOYER:

ADDRESS (Street, City, State, Zip):

WORK PHONE:    HOME PHONE:

FAX:    EMAIL:

HAVE YOU PREVIOUSLY PRESENTED AT AN UAHPERD CONFERENCE? (select one)   Yes   No

PRESENTER QUALIFICATIONS (briefly highlight):

REQUESTED PROGRAM TYPE: (select one)
Lecture/Discussion   Panel Discussion   Activity Program   Poster Session  

SUGGESTED DISCIPLINE OR INTEREST AREA:
Elem   MS   HS   University
Adapted   PE   Dance   Rec   Health   Research   Coaching   Fitness  

PROGRAM DESCRIPTION: Type a brief description (100 words or less), that may be used to promote this program and to include it in the program book. This description should be clear, concise, and bold. The words and ideas should help to attract attendees to your program. Take time to prepare this description with information that may stir the interest of professionals in attendance. This description is all that may be available to attendees in helping them to decide which session to attend. (Please include the type of facility being requested such as "gym, classroom, etc.")

PROGRAM PRESIDER: This individual may be you, a co-presenter, or someone you ask that will be responsible for introducing speakers and assuring that the session begins and ends promptly.

PROGRAM SUB-TOPICS AND SPEAKERS: For more than one presenter, list any sub-topics (if applicable) and co-presenter(s) name, place of employment, city,and state. Note: Please ensure all information is complete otherwise program information will be incorrect.

ADA INFORMATION: If a presenter needs special accommodations due to a disability, please explain the special requirements needed.

CHANGE POLICY: If your program is accepted and you need to submit a change, it must be received by October 1, 2008. After this date, ABSOLUTELY NO CHANGES WILL BE ACCEPTED. Please email your changes to Daniel Balderson at danielbalderson@weber.edu and indicate in the subject this is a "Change in Approved Convention Program".

Submission of this proposal is an "Acknowledgement".

PROGRAM LEAD PRESENTER ACKNOWLEDGEMENT: I acknowledge that I have read and understand all directions outlined in this document. I have discussed the above with each co-presenter involved in this program and understand the policy concerning changes once this program has been submitted. I understand that all proposals must be received by September 15, 2007. If the proposal is accepted for presentation, I understand that I am responsible for paying for all travel-related expenses and the required registration fees. I have informed my co-presenters of this responsibility.