3rd Annual International Youth Conference on
"The Ecology of War and Peace"

Dates: May 5-13, 2007 Site: St. Petersburg, Russia
( Formal Conference Program: May 6-11 )

Presenter Proposal Form
( PLEASE TYPE OR PRINT CLEARLY)

1. Presenter & credentials___________________________________________________________

Address _________________________________________________________________________

_______________________________________________________________________________

Phone day ( ___ ) ________________________ evening ( ___ ) _____________________________

Fax ( ___ ) _______________________ E-mail __________________________________________

2. Workshop/Presentation Title (for printed program - maximum 12 words): _______________________________________________________________________________

_______________________________________________________________________________

3. Presentation Brief Description (for printed program - maximum 45 words).
Please be clear & direct about what you are going to do:

_______________________________________________________________________________

______________________________________________________________________________

_______________________________________________________________________________

4. Personal Statement/Professional Biography (for printed program - max. 25 words).
Please include credentials/degrees and positions.
______________________________________________________________________________

______________________________________________________________________________

_________________________________________________________

Co-presenters: If you have co-presenters, please copy this form as each presenter will
need to complete personal information. A brief vita for each presenter should be included.
_________________________________________________________

5. Length: Day program sessions are 2 hours in length. (Note: Allow time for live translation intervals -
translation is sequential and takes approximately 1/2 the total presentation time). If you wish to propose an
evening youth event, these sessions are 1-2 hours in length

6. Instructional Format (interactive formats are the most effective and popular), Check all that apply:
[ ] Experiential [ ] Movement [ ] Demonstration
[ ] Discussion [ ] Roundtable [ ] Lecture

7. General Topic Area (check no more than 2):
    [ ] Arts/Creativity                  [ ] Cross-Cultural/Ethnic [ ] Deep Ecology/Environmental
    [ ] Economics/Business           [ ] Education               [ ] Gender
    [ ] Global/Regional Conflict       [ ] Health/Healing Arts      [ ] Human Rights
    [ ] Organizational/Community   [ ] Psychotherapy          [ ] Transpersonal/Spiritual

8. Any Equipment Needed: ___________________________________________________

9. Checklist of Requested Information:
[ ] Title of Presentation
[ ] Brief Description of Presentation (use separate sheet if necessary)
[ ] Personal Statement/Biographical (use separate sheet if necessary)
[ ] Full Description of Presentation: (200 words or less - on a separate sheet,
        including a statement describing your qualifications & familiarity with the subject)
[ ] A Current Brief Resume and/or curriculum vita for all presenters and
          co-presenters
[ ] Two Professional References (names, position, and contact information). E-mail
         addresses are preferred (or if unavailable, fax numbers) for references outside
         the US. For references within the US include phone, fax, and e-mail.
[ ] When We Can Reach You (best days & times):________________________

10. If you are a licensed practitioner, has your professional license or insurance ever been on probation, suspended, or revoked?
[ ] Yes [ ] No If yes, please explain on a separate sheet.

11. Taping: Conference sponsors request the right to tape conference presentations for professional use.
[ ] I Agree to let my Presentation be Taped or Photographed.
________________________________ _____________________
Signature Date

12. A collection of Articles submitted by conference presenters relevant to their presentations at this conference is being
generated for publication in a virtual journal on our web site. Would you wish to contribute such an article?
[ ] Yes [ ] No

Proposal Submission

Please submit proposals by E-mail (preferred), fax, or land mail to Common Bond Institute using the contact information listed below.

SUBMISSIONS REQUESTED BY: March 1, 2007
( Early submission is recommended for best choice of sessions.
Submissions after this date are considered for evening or replacement sessions as space permits )