16th
International Conference
on Conflict Resolution
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Presenter Proposal Form
( PLEASE TYPE
OR PRINT CLEARLY)
1. Presenter & Credentials _______________________________________________________
Address ______________________________________________________________________
_______________________________________________________________________________
Phone day ( ___ ) ________________________ evening ( ___ ) _____________________________
Fax ( ___ ) _______________________ E-mail _______________________________________
Website ______________________________________________________________________
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; each presenter will
need to complete personal information. A brief vita for each presenter should be included.
_________________________________________________________
5. Length: Choices are: 2, 3,
or 4 hours sessions. Workshops are typically 3 or 4 hours. Lectures are typically
2 hours.
There may also be some all-day institute slots available (7 hours).
All sessions are encouraged to include interaction.
(Note: Allow time for live translation intervals - translation is sequential
and takes approximately 1/2 the total presentation time)
* Please indicate your 1st & 2nd choice of these time blocks.:
1st choice:_____________ 2nd choice:______________
6. Instructional Format (interactive
formats are the most effective and popular). Check all that apply:
[ ] Experiential [ ] Movement [
] Demonstration [ ] Discussion
[ ] Roundtable [ ] Lecture
[ ] Multimedia
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
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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: February 1, 2009
( Early submission is recommended for best choice of sessions.
Submissions after this date are considered for evening or replacement sessions as space permits )
Common
Bond Institute
Steve Olweean, Director,
SOlweean@aol.com
12170 S. Pine Ayr Drive
Climax, Michigan
49034
USA
1.269.665.9393 (phone and fax)
Website:
http://www.cbiworld.org
CONTACT
US!
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