Would You Like To Present At The Rhode Island
Fall 2006 Conference?
The 2006 RIAHPERD Fall Conference is presently being planned. Shortly you may submit a proposal on this form by July 30, 2006. You can print out and mail this form to: Mike Pucino - RIAHPERD Fall Conference Committee - 188 Briarbrook Drive, Seekonk, MA 02771, or highlight, copy, and paste it into a Word document and attach it to an email to Mike at: ellie4sun@msn.com.
Name:
Job Title:
Mailing Address:
Telephone Number : Home Work
Fax: Email:
Title of Proposed Session:
Discipline (Physical Education, Health, etc.) Other
Target Audience:
List any previous presentation experience
Description of your Proposal (Including Objectives of the Session):
Format:
Audio visual Needs:
Will you be bringing equipment or supplies (handouts)? Yes No
Describe:
Please list a brief biographical summary of yourself and your work for the Presider to use when
introducing you to the participants: