2011 Conference Presentation Submission Form

(Items marked with * are required.)
Before completing your submission form, gather all necessary information including: (a) full name(s) of each presenter, (b) affiliation for each presenter, and (c) the Abstract for each presentation. Learning Objectives are required for some presentation types, as indicated below. First, you may prepare a Word or TextEdit file so you can easily copy and paste information into the form below. To navigate the form, use the Tab key to advance from one field to another, or the Shift + Tab keys to go back to a previous field. When you are done with your submission hit "Submit Presentation" at the bottom. You will receive an email notification within a few minutes.

Presentation ID: Not Saved
*Type of Presentation: -- for more information Click Here.
Ignite: Talks are exactly five minutes long. Ignite presenters share their professional passions for some aspect of ABA, using 20 slides that auto-advance every 15 seconds.
Paper: 50 minutes   80 minutes
Symposium: 50 minutes   80 minutes
Panel Discussion: 50 minutes   80 minutes
Poster (Note: Posters are NOT eligible for continuing education)
Workshop:  3 hours
*Knowledge level:
     Introductory (for participants with little or no formal training in the subject matter)
Intermediate (for participants with at least undergraduate training in the subject matter)
Advanced (for participants with advanced training in the subject matter)
Maximum # of participants:  Maximum # of participants is 50
*Preferred workshop date:
Wednesday September 21
Saturday September 24
I can present either day. I have no scheduling conflicts.
*Primary Area:
Audio-Visual Equipment Needs:
FABA will provide LCD projectors and screens in all presentation rooms, plus microphones for larger rooms. Presenters will need to bring their own laptop computers. Those using Mac computers will need to provide their own cable adapters. Internet access or any other equipment needs are the responsibility of the presenter and may be ordered by contacting Terrence Uzzell at tuzzell@swankav.com Phone is: 386-944-1390.

*Title of Presentation (maximum of 20 words):

Submitting Author:
*First Name:  M.I.: .  *Last Name:
*Salutation:     *Highest Degree:    Other:
Lic/Cert1:    Lic/Cert2:    Other:
*Affiliation:
(Enter COMPLETE MAILING ADDRESS below, INCLUDING AFFILIATION if applicable.)
*Street Address:
Street Address Line 2:
Street Address Line 3:
*City:   State:   *Postal Code:   
*Country:
*Email:   *Tel:   Fax:

*Abstract (minimum 50 words, maximum 150 words). For a symposium, provide an abstract for the symposium as a whole, and an abstract for each presentation below.


(Author names or initials only. Do not include degrees, certifications, or titles - e.g., "Dr," "PhD," "BCBA." The first Author is the Presenting Author. Enter first name and then last name.)

             First Name                    Last Name
Author:      Affiliation:
Author:      Affiliation:
Author:      Affiliation:
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Author:      Affiliation:
Learning Objectives: Participants will be able to...
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(Author names or initials only. Do not include degrees, certifications, or titles - e.g., "Dr," "PhD," "BCBA." The first Author is the Presenting Author. Enter first name and then last name.)

                    First Name                    Last Name
Chair:                Affiliation:
Discussant:      Affiliation:

Symposium papers and presenters:
Title 1:

             First Name                    Last Name
Author:      Affiliation:
Author:      Affiliation:
Author:      Affiliation:
Author:      Affiliation:
Author:      Affiliation:
Author:      Affiliation:
Abstract (minimum 50 words, maximum 150 words):


Title 2:

             First Name                    Last Name
Author:      Affiliation:
Author:      Affiliation:
Author:      Affiliation:
Author:      Affiliation:
Author:      Affiliation:
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Abstract (minimum 50 words, maximum 50 words):


Title 3:

             First Name                    Last Name
Author:      Affiliation:
Author:      Affiliation:
Author:      Affiliation:
Author:      Affiliation:
Author:      Affiliation:
Author:      Affiliation:
Abstract (minimum 50 words, maximum 150 words):


Title 4:

             First Name                    Last Name
Author:      Affiliation:
Author:      Affiliation:
Author:      Affiliation:
Author:      Affiliation:
Author:      Affiliation:
Author:      Affiliation:
Abstract (minimum 50 words, maximum 150 words):

Learning Objectives: Participants will be able to...
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(Panelist names or initials only. Do not include degrees, certifications, or titles - e.g., "Dr," "PhD," "BCBA.")

                First Name                    Last Name
Chair:           Affiliation:
Panelist:      Affiliation:
Panelist:      Affiliation:
Panelist:      Affiliation:
Panelist:      Affiliation:
Panelist:      Affiliation:

Learning Objectives: Participants will be able to...
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(Presenter names or initials only. Do not include degrees, certifications, or titles - e.g., "Dr," "PhD," "BCBA.")

                  First Name                    Last Name
Presenter:      Affiliation:
Presenter:      Affiliation:
Presenter:      Affiliation:
Presenter:      Affiliation:
Presenter:      Affiliation:
Presenter:      Affiliation:

3 Hour - Learning Objectives: Participant will be able to...
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*Presenter's Short Biography

Please note here any details, special considerations, or other information that may be helpful to the FABA Conference Committee regarding your submission:
By selecting "I Agree" below, the submitting author affirms and represents that the information above, and all attachments hereto, are true and accurate, and agrees to deliver the presentation or arrange for it to be presented if the submission is accepted by the FABA Conference Committee. The submitting author understands that all presenting authors must register for the conference, and that failing to deliver an accepted presentation or arrange for it to be presented may result in rejection of future submissions from this author

*Agreement:
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