EmailMe Form - LSWO Chicago Conference 2016 (October 13-14, 2016)

Primary Contact Speaker

First Last

Primary Contact Email

Primary Speaker License/Credentials

2nd speaker (if applicable)

First Last

2nd Speaker License/Credentials

3rd speaker (if applicable)

First Last

3rd Speaker License/Credentials

Organization Name

Twitter handle/name

Web Site

Address of Primary Speaker

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Phone

### - ### - ####

Title of Workshop Proposal

Provide your teaching methods

Provide 4 objectives for your workshop

Attach your resume(s), Title of Proposal, Brief Overview, Abstract.