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Proposal Submission Deadline Extended to October 16, 2009
Notification of acceptance on or before November 15, 2009

Presentation Title (12 words or less)

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Presenting Author (for paper session) or
Lead Presenter (for panels) Information:

Please insert information for the presenting author for a paper session or the lead presenter for a panel or workshop.

Name:

Degree:

Title:

Affiliation:

Phone:

Address 1:

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Address 2:

Email:

City:

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       Zip:           Country:

Additional Presenter/Author #2

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Degree:

Title:

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Address 1:

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Address 2:

Email:

City:

State:

       Zip:   Country:

Additional Presenter/Author #3

Name:

Degree:

Title:

Affiliation:

Phone:

Address 1:

Fax:

Address 2:

Email:

City:

State:

       Zip:   Country:

Additional Presenter/Author #4

Name:

Degree:

Title:

Affiliation:

Phone:

Address 1:

Fax:

Address 2:

Email:

City:

State:

       Zip:   Country:

Abstract (75 word maximum)

Please copy from your word processing program, verifying word count, and paste into box below.

Acknowledgement & Disclaimer:  The CMHS National GAINS Center reserves the right to edit the summary.  Please be clear and concise, the abstract will be included in the conference program book.

Summary (250 word maximum)

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Acknowledgement & Disclaimer:  The summary will be reviewed by the CMHS National GAINS Center staff - staff will base the acceptance of the proposals on the quality and clarity of the presentation narrative and program content as it relates to the conference theme.  The summary will not appear in the conference program book. 

Learning Objectives

Include 2 objectives no more than 25 words each. Objectives are statements in specific and measurable terms that describe what an attendee will know or be able to do as a result of taking part in your session.

Objective 1:

Objective 2: