5th Annual St. Joseph’s College Conference in Conjunction with LILSA www.lilsa.org April 17, 2015 / St. Joseph’s College, Patchogue NY Educational Session Proposal/Continuing Education Unit Approval Form The 2015 Annual Conference Program Committee invites you to submit your session proposals for the 5th Annual Conference Program. Proposal will be accepted through FEBRUARY 17, 2015 Please complete and return to: rd Anthony Martino, 26041 73 Ave, Glen Oaks, NY 11004 amartino@nshs.edu Tom McGerty tmcgerty@gardencityny.net Online submission https://docs.google.com/forms/d/1EfWENCOW1FKyxMWBIR_6rjFCbCCeXYEcLHxM_IHmA/viewform https://sites.google.com/site/recreationnews/ Session/Program Title: ( Limit to 7 words) _____________________________________________________________________________________ Session Description: ( 70 words or less; please use other sheet, if needed) _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _________________________________________________________________________________ Describe the educational needs that this session will be addressing ( Needed for CEU approval) . _____________________________________________________________________________________ _____________________________________________________________________________________ __________________________________________________________________________________ List Three Objectives this session will teach (Needed for CEU approval) . Start with the participant will……..and then please use words such as Define, Explain, Describe, Record, Identify, List, Outline, Recognize, Recall, Restate, and Summarize when stating your objective. 1.___________________________________________________________________________________ 2.___________________________________________________________________________________ 3.___________________________________________________________________________________ Please identify which educational track(s) you believe are applicable to this session: Foundational Knowledge Advancement of the Profession Planning Organizational Knowledge of TR/RT Communication Policy Practice of TR/RT Finance Operations Human Resources Programming Target Audience: (Circle all that apply) Therapeutic Recreation Young Professionals Administrators Parks Staff Supervisors Cultural Arts Programming Seniors Students Sports Session Format: (Circle all that apply) Interactive Lecture Lecture Handson Facilitated Roundtable Tour Offsite Other facebook.com/longislandleisuresociety Maintenance Trails Park Resources Sustainability Panel Presentation twitter.com/LILSANews CONFERENCE SESSION PROPOSAL FORM – Speaker Information Please complete the following information. Use additional sheets if necessary. A Resume for each speaker MUST be submitted with this form. Speaker Resume attached: Yes No Speaker Name: ________________________________________________________________________ Title: __________________________________ Agency: _______________________________________ Address: _____________________________________________________________________________ City: ___________________________________________State: ______________ Zip: ______________ Work Phone: ___________________Home Phone: ________________________ Fax: ______________ Email Address: ______________________________________ Current Member of NYSRPS? Yes No Speaker Name: ________________________________________________________________________ Title: __________________________________ Agency: _______________________________________ Address: _____________________________________________________________________________ City: ___________________________________________State: ______________ Zip: ______________ Work Phone: ___________________Home Phone: ________________________ Fax: ______________ Email Address: ______________________________________ Current Member of NYSRPS? Yes No Speaker Name: ________________________________________________________________________ Title: __________________________________ Agency: _______________________________________ Address: _____________________________________________________________________________ City: ___________________________________________State: ______________ Zip: ______________ Work Phone: ___________________Home Phone: ________________________ Fax: ______________ Email Address: ______________________________________ Current Member of NYSRPS? Yes No I will need: (Circle all that apply) All rooms are smart rooms with computers and projectors DVD Player Flip Chart No A/V Needed Preferred Room arrangement: Classroom/rows of chairs Activity (open area with chairs along the wall) U shaped SPEAKER/S LAST NAMES: ______________________________________________________________ No Abstract will be accepted and processed for review without a Resume/Bio per speaker. Submission Deadline through February 10, 2015 facebook.com/longislandleisuresociety twitter.com/LILSANews
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