Application for Presentations

What is your name?*

First Last

What is your degree and license?*

What is the title of the talk you wish to present?*

How many hours do you wish to present?*

What date(s) would work for your presentation?*

Please include an abstract (200-250 words) describing your talk?*

What are the learning objectives for your presentation? You should have about 1-3 learning objectives per presentation hour.*

What level of therapist is the target audience?*

What sexual, gender, or relationship expansive population does your presentation focus on?*

If you chose Other, please list:

What is your expected compensation?*

How many years of experience do you have working with this population?*

What is your phone number?*

What is your email address?*

Please attach your CV.*

Max. file size: 40 MB.

Comments

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