EmailMe Form - AFP MA Education Program

Your Name *

Your Title *

Your Organization *

Your State/Province/Region *

Your Email Address *

Your Phone Number *

Workshop Title *

Workshop Description - to be used for event promotions (150 word max) *

How do you plan to achieve an interactive learning experience with the audience during the presentation? (150 word max) *

List any co-speakers who will be presenting this workshop with you (Name, Organization, Email Address)

Proposed workshop length

60 Minutes

75 Minutes

90 Minutes

Proposed workshop structure

Single Speaker

Multiple Speakers

Panel

Vendor/Client

For which audience is this workshop intended?

Small Shops

Mid Shops

Large Shops

Proposed training level

Please check applicable audiences for whom this is intended.

Beginners

Emerging Leaders

Senior Officers

Other

How do you envision your session being set up

Small controlled size (30 or less), highly interactive

Midsized (100 or less), somewhat interactive

Large size (1000 or less), lecture style (little interaction)

Please check applicable audiences for whom this is intended.

Please choose the track that is MOST relevant to your session.

Please choose the track that is SECOND most relevant to your session.

Please choose the track that is THIRD most relevant to your session.

List key take-aways for attendees (optional)

Session outline (optional)

Please tell us about any time/date preferences or restrictions (optional)

Were you referred to us by anyone at AFP MA and if so whom? (optional)

Do you give the chapter permission to record your session to share with the attendees? Please note, agreeing is not required to present.

Yes

No

Thank you for taking the time to submit a workshop idea to AFP MA Chapter. Your form will be forwarded to the Education Committee for review. We'll be in touch!