2010 Conference Presentation Submission Form

(Items marked with * are required.)
Before you proceed to fill out your submission form you should have all the necessary information. You will need a) name of each presentor, b) affiliation for each presenter, and c) the Abstract for each presentation. You may also need Learning Objectives depending on the type of presentation you are submitting. It is a lot easier to have this ready on your desktop in a Word or TextEdit file so you can cut and paste the information where needed. Also note that you can use the Tab key to advance from one field to another. Use Shift + Tab 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:

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 6 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 Oct. 6
		Saturday Oct. 9 (Morning only, only 3-hour workshops)
		I can present either day. I have no scheduling conflicts.

*Primary Area:

Audio-Visual Equipment Needs:
All rooms will be equipped with an LCD projector and screen, presenters will need to bring their own laptop computers. Microphones will be supplied for larger rooms. Any other equipment needs are the responsibility of the presenters and may be ordered by contacting Melissa Badendyck at MBadendyck@smartcity.com or by phone at 407-828-6961.

*Title of Presentation (maximum of 20 words):

Submitting Author:
*First Name: M.I.: . *Last Name:

*Highest Degree: Other:

Lic/Cert1: Lic/Cert2: Other:

*Affiliation:

*Street Address:
Street Address Line 2:
Street Address Line 3:

*City: State: *Postal Code: Country:

*Email: *Tel: Fax:

*Abstract (minimum 100 words, maximum 250 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.")

Presenting Author: Affiliation:

Author: Affiliation:

Learning Objectives:

(Author names or initials only. Do not include degrees, certifications, or titles - e.g., "Dr," "PhD," "BCBA.")

Chair: Affiliation:

Discussant: Affiliation:

Symposium papers and presenters:

Title 1:

Presenting Author: Affiliation:

Author: Affiliation:

Abstract (minimum 100 words, maximum 250 words):

Title 2:

Presenting Author: Affiliation:

Author: Affiliation:

Abstract (minimum 100 words, maximum 250 words):

Title 3:

Presenting Author: Affiliation:

Author: Affiliation:

Abstract (minimum 100 words, maximum 250 words):

Title 4:

Presenting Author: Affiliation:

Author: Affiliation:

Abstract (minimum 100 words, maximum 250 words):

Learning Objectives:

(Panelist names or initials only. Do not include degrees, certifications, or titles - e.g., "Dr," "PhD," "BCBA.")

Chair: Affiliation:

Panelist: Affiliation:

Learning Objectives:

(Presenter names or initials only. Do not include degrees, certifications, or titles - e.g., "Dr," "PhD," "BCBA.")

Presenter: Affiliation:

3 Hour - Learning Objectives (5)

6 Hour - Learning Objectives (8)

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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