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Workshop Proposal Form

Each presenter must complete and submit a copy of this form with proposal for panel presentation.
Please provide all the information requested to enable the Congress Committee to evaluate proposals.

The deadline for submitting a proposal is May 2008.


Presenter

Name

Address
City
State/Country:
Zip:
Office Phone:
Home Phone:
Fax:
Email
Website

I am a member of IARRT Yes No
I am a member of EARTH Yes No
I am Certified by IBRT Yes No
I am a member of (others):
Co-presenter

Name

Address
City
State/Country:
Zip:
Office Phone:
Home Phone
Fax:
Email
Website

I am a member of IARRT Yes No
I am a member of EARTH Yes No
I am Certified by IBRT Yes No
I am a member of (others):

All proposals must include:(please send typed proposal including the following form below)

1. Title of Workshop  (Title should accurately describe content of workshop in 5 –10 words –main title with brief subtitle.)
2. Aims of the workshop (Short description of the workshop.)
3. Target Audience

Intermediate-Advanced
Advanced
All Levels

4. Audio/Visual Equipment Request (please check as appropriate or indicate “nothing needed”)

Flip chart/Black Board
Overhead Projector
VHS/DVD Player/Monitor
Nothing Needed

Congress Committee will do their best to meet above requests and needs. Presenters will be notified on approval of proposal if time requests and equipment needs can be provided.

5. Objectives
Briefly state objectives of presentation.
To Workshops include 5 items in bullet format participants will be able to do after attending your workshop or Training.

6. Description
A brief 75 word description of content of your presentation. This description will be used in marketing purposes, please be sure to use clear and conversational language. Include how and why the participants will benefit from your presentation. All workshops must include demonstration or experiential component.

7. Handouts
Please include 1-4 pages that will help clarify or offer additional information about your workshop training.

8. Presentation
Please include a detailed description of the outline of your Workshop. Include an agenda of the content you plan to present and the amount of time given to lecture/discussion and experiential. Each Workshop should be at least 50% experiential and teach skills Regression Therapists can use after your presentation.

9. Biographical Information
Please include a 75 word biography that highlights background relevant to this
Proposal and also educational background. Be sure to include co-presenter in this description if co-presenting.

10. Experience in the Field of Regression Therapy
Include detailed information about your experience and training in the field of Regression Therapy. Include practical experience, teaching experience, personal research in the field, published books and articles, previous speaking experience, etc. Relevant titles, memberships, professional qualifications.

Commitment Term
I have carefully completed the required information request as stated in the above forms. I have read and understand the rules and requirements and agree to cooperate with the World Congress Committee and Staff on administrative details and deadlines. I understand that if I fail to meet the deadlines and required statements above I may be unable to participate as a presenter at the Congress Program. I take full responsibility for myself and my information.


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