CCID 34th Annual Conference

Name:
Position:
Institution:
Address:
City, State, Zip:
Country:
Phone:
Fax:
Email:

Type of Presentation
(if you plan to present more than once or in a different category, please kindly complete separate submission forms):
Concurrent Session:	Plenary Session:	Preconference Workshop:
45 minutes incl.10-minute Q&A discussion (avg. 35-50 participants)	1 hour (all conference participants)	3 hours incl. breaks (approx. 30 participants) [contact CCID office to follow up on this submission please]

Presentation Title (For use in the Conference Program brochure):
(CCID reserves the right to shorten or modify the presentation title)


Annotation of the Presentation (For use in the Conference Program brochure):
Maximum 10 sentences (75 -100 words) to describe the goals, content, and likely audience for your presentation. We suggest it clearly states the content of the presentation. Type in, or copy and paste from any electronic document, in the box below:

Please provide a 300-word Presentation Overview: Attach an overview file (please make sure the file name has the presentation title and your name/ teammate names in it). The file needs to be in MS Word format. If you are not using MS Word, please save the file as RTF format. We apologize but we cannot accommodate MAC-formatted files. This text will be used to select your presentation for the conference. TIPS FOR PRESENTATION: CCID prefers presentations which provide theoretical or practical recommendations, lessons learned, solutions to any programming barriers/ threats, best practices for quality improvement, specific benefits, policy recommendations, research findings relevant to the conference theme or tracks, or other issues that enhance knowledge and understanding of the conference participants of a specific presentation topic. Recounts of WHAT programs did for institutions or their constituents or WHAT institutions offered in international programming without providing any specific benefits/ outcomes (WHY sthg was done) will not be considered for presentation.

Audio Visual Equipment Request (PLEASE READ!):

CCID will provide: LCD projectors, laptops, screens, cart/table, and extension cords for plenary sessions and concurrent (breakout) sessions for which the equipment was requested. We will have a sufficient number of LCD projectors for powerpoints available, however, if you prefer to use your own, we encourage you to bring it (including special cords). Same applies to laptops/ notebooks.
Please indicate below what equipment you require for your presentation or whether you will bring your own. NO indication will mean NO equipment is needed - so please complete this form in your own best interest.

If you are using AV equipment supplied by CCID, please bring your presentation on a CD ROM or a "flash/ pen/ memory" drive. We will not be able to accommodate other types of media holders. In case you want to play a brief video, pleasde advise the CCID Office as we need to ensure there is a proper audio projections available. We advise to bring the video on a DVD disc.

NOTE: CCID does not provide copying service for presenters during the conference. We apologize for any inconvenience (Attendance in concurrent sessions varies but we would recommend making and bringing around 30-40 copies of materials).

At the event, CCID collects electronic copies of your presentations which are posted on the CCID web after the conference. This ensures that if you did not have enough handouts that your presentation reaches all who attended the session as well as those who were unable to do so.

I require a notebook/ laptop: yes no will bring

I require LCD projector: yes no will bring

Audio/Video Tape Release:

I authorize the taping of and offering for sale taped copies of my presentation at the CCID Annual Conference. This authorization is granted on the understanding that the grantee will not assert any copyright or deprive me of any rights I may have in the materials I present. Failure to submit this form by November 17, 2008 will assume to be consent.

This authorization is granted to CCID and its audiovisual subcontractor(s):
yes no

Biographical Information (for use in the Conference Program brochure):

Attach a biographical information for yourself and for any additional presenters (provide their names, titles, institutional affiliation, etc. in the "Team Presentations" forms below) in a PARAGRAPH FORMAT of 200 words and less (for each presenter).

If you are having trouble attaching your biographical information here or any of the files above, you can also email it as an attachment to an email to Andrea Siebenmann at asieben@kirkwood.edu.
NOTE: Biographical information will appear in the Conference Program brochure exactly as CCID receives them. We regret any inconvenience, but the best format is MS Word 2003/2007 or RTF if you are converting from other applications. We cannot accept MAC-formatted documents.

Team Presentations (If you entered your name above, DO NOT enter it again):

If you are presenting with colleagues from the same or other institutions, please be aware that all presenters must register for the conference (at a "Presenter" rate). Please provide contact information on ADDITIONAL co-presenters below:

Name:		Name:
Title:		Title:
Institution:		Institution:
Address:		Address:
Phone:		Phone:
Fax:		Fax:
Email:		Email:

Name:		Name:
Title:		Title:
Institution:		Institution:
Address:		Address:
Phone:		Phone:
Fax:		Fax:
Email:		Email:

Policy Agreement:

If my Presentation Proposal is accepted I agree that it is a voluntary contribution to CCID, and that I will not receive an honorarium or expense reimbursement.
I agree to register and pay the conference registration fee assigned for presenters.
I authorize CCID to publish the conference materials. I waive my rights to receive any fees or royalties associated with the conference.
I have contacted all my co-presenters in this program, to secure their agreement to register for the conference, pay the conference registration fee, and appear in this presentation.
If I need to cancel my presentation I will do so in writing to CCID no later than January 20, 2010.

Agree

Disagree

Please make sure you keep a hard copy of your submission
and print it before pressing the "Submit Form" button below.