2019 CALPCC Conference Proposal Form Step 1 of 2 50% Number of Presenters*1234PresenterName* First Last TitleInstitution/AgencyEmail* Enter Email Confirm Email PhoneCALPCC Member?YesNoBrief Bio*75 words maxQualifications*Please indicate how the lead presenter meets at least two of the following four minimum qualifications (required for participants to receive CEUs for your session): Current, valid, unrestricted license, registration, or certificate in an area related to the subject matter of the course: Master’s or higher degree from an educational institution in an area related to the subject matter of the presentation: Training, certification, or experience in teaching subject matter related to the subject matter of the presentation: At least two years experience in an area related to the subject matter of the presentation: Presenter 1 - CV/Resume*Please upload Resume/CV in pdf formAccepted file types: pdf.Presenter #2Name* First Last TitleInstitution/AgencyEmail Enter Email Confirm Email PhoneBrief Bio*75 words maxCALPCC Member?*YesNoPresenter 2 - CV/Resume*Please upload Resume/CV in pdf formAccepted file types: pdf.Presenter #3Name* First Last Title*Institution/Agency*Email* Enter Email Confirm Email Phone*Brief Bio*75 words maxCALPCC Member?*YesNoPresenter 3 - CV/Resume*Please upload Resume/CV in pdf formAccepted file types: pdf.Presenter #4Name* First Last Title*Institution/Agency*Email* Enter Email Confirm Email Phone*Brief Bio*75 words maxCALPCC Member?*YesNoPresenter 4 - CV/Resume*Please upload Resume/CV in pdf formAccepted file types: pdf. Presentation InformationPresentation Title*(15 word maximum)Abstract*120 word maximumSession Summary*Session Summary, including overview; clinical, scholarly, or scientific significance; session structure/outline (500 word maximum)Learning ObjectivesLearning objectives should be concise. Each one should be one to two sentences in length. Begin with the sentence stems indicated below and use verbs such as: demonstrate, identify, conduct, implement, examine, articulate. Learning Objective 1*By attending this session, attendees will be able to … Learning Objective 2*By attending this session, attendees will be able to … Learning Objective 3*By attending this session, attendees will be able to … Please indicate how this presentation relates to the conference theme.*This year's theme: "Counseling in a Divisive Society: Collaboration, Growth, and Change" Consent for recording of presentation:*Please indicate your consent for yourself and on behalf of all other presenters so that the presentation can be audiotaped and/or videotaped if the submission is accepted and the session is selected for recording by CALPCC. YesNoIdentify the track for which you are submitting an education, roundtable, or poster session* Professional issues related to law and ethics Culturally competent counseling and supervision Working with couples and families Crisis and trauma counseling, trauma-informed care School mental health counseling Sociopolitical factors in counseling Transgenerational issues in counseling Serving historically marginalized communities (e.g., LGBTQ, communities of color, persons with disabilities, immigrants, etc.) Interprofessional collaboration and Integrated Behavioral Healthcare The LPCC and professional identity The Mental Health Recovery Model Identify the type of presentation you are submitting:* Education Session: 90-minute educational presentation Roundtable Discussion: 90-minute session with multiple roundtable discussions occurring at the same time, with a moderator leading the discussion Poster Session: The poster session can showcase the presenters’ research project, concepts, and/or scholarly interests related to the conference theme. Should your presentation not be selected for an education session, will you agree to present a roundtable session or poster session:*YesNoCALPCC welcomes persons with disabilities and will provide reasonable accommodations upon request. If you need reasonable accommodations to complete this proposal submission, please contact jchronis@sfsu.edu as soon as possible so your request may be reviewed. This iframe contains the logic required to handle Ajax powered Gravity Forms.
