Presenter Form

SWATCA Presenter Form

Fields marked with a * are required.

Referrer Name: *

Referrer Email: *

Speaker: *

Address: *

City/Prov: *

Postal Code: *

Phone: *

Cell: *

Fax: *

Email Address: *

School/Institute: *

Honorarium:*

Honorarium Amount:

If there will be two presenters please fill in the information below:

Name:

Address:

City/Prov:

Postal Code:

Phone:

Cell:

Fax:

Email Address:

School/Institute:

If there will be three presenters please fill in the information below:

Name:

Email Address:

Travel

Speaker is traveling by Air: * Yes No

If yes, Speaker must make own arrangements.

Cost:

Speaker is traveling by Car:* Yes No
Travelling from:

Vicinity of Lethbridge (actual km @ $0.40):

Parking Pass required:* Yes No

Accommodation

Room Needed* Yes No Smoking Non-smoking Wed Thurs

Information About The Presentation

1. Time: (Please check one)* Workshop - 90 minutes
Session Half Day (3 hours)
Other 2. Type of Room: (Please check one)* Tiered Classroom Space
Moveable Desks
Art Studio Space
Empty Room (no desks)
Computer Lab
Other

3. Presentation Title:*

4. Description of Topic for Web Site [30 wds max] *

5. Presentation Summary: Please provide details of your session/workshop content and activities [150-200 words] *

6. Speakers Biography: [50 wds max]*

7. Topic & Subject Tracks: *

Administration & Leadership
Art
Assessment
Career and Technology Studies and Foundations
Curriculum and Pedagogy
Drama and Dance
Educational Research
English Language Learning
Environmental and Outdoor Education
Religious and Moral Education
Education for Reconciliation
French and International Languages
Guidance and Student Support
Health, CALM, and Wellness
Inclusion and Diversity
Keynotes and Special Events
Language Arts
Learning Commons
Mathematics and Numeracy
Music and Band
Physical Education
Science
Social Studies
Special Education
Teacher Wellness
Technology

8. Audience Track: *

Early Childhood (Pre K - K)
Division 1 (Gr 1 - 3)
Division 2 (Gr 4 - 6)
Division 3 (Gr 7 - 9)
Division 4 (Gr 10 - 12)

9. AV and Other Requirements: * Overhead Projector Sink LCD Projector
Smart Board - There are a small number available, so please check if absolutely necessary only.

Other AV:

10. You must read and agree to the SWATCA speaker guidelines: *

I have read and agree to the SWATCA speaker guidelines