To be submitted to the Conference Director Monica McAbee and the MLA office, by October 15, 2010. All fields, except the Comments field, are required.

Sponsoring Unit

Topic of Program

Proposed Day Wednesday (Pre-Conference Only) Thursday Friday

Time AM PM

Length of Program

Pre-Conference Select Length of Program 1/2 Day Full Day

Conference Select Length of Program 1 hour 15 minutes 2 hours 45 minutes

Learning Objectives - (At the conclusion of the program, participants will be able to...)
Remember--Objectives must be measurable

Format (Structure of program, e.g. hands-on workshop, lecture with Q & A, panel, etc.)

Suggested Speaker(s)

Estimated Size of Audience

Program Planner

Contact Name

Email

Phone

Fax

Additional Comments

Please verify all information before submitting this form. Thank You.