Please fill in your information below.
Proposal Submission Deadline Extended: October 30, 2007
Notification of acceptance on or before November 30, 2007

Presentation Title (12 words or less)

Enter Title:

Type of Presentation:

Paper Panel Poster Video

Presenting Author or Lead Presenter Information:

Please insert information for the presenting author for a paper session or the lead presenter for a panel or workshop.

Name:

Degree:

Title:

Affiliation:

Phone:

Address 1:

Fax:

Address 2:

Email:

City:

State:

       Zip:           Country:

Presenter/Author #2

Name:

Degree:

Title:

Affiliation:

Phone:

Address 1:

Fax:

Address 2:

Email:

City:

State:

       Zip:   Country:

Presenter/Author #3

Name:

Degree:

Title:

Affiliation:

Phone:

Address 1:

Fax:

Address 2:

Email:

City:

State:

       Zip:   Country:

Presenter/Author #4

Name:

Degree:

Title:

Affiliation:

Phone:

Address 1:

Fax:

Address 2:

Email:

City:

State:

       Zip:   Country:

Summary (75 word maximum)

Please copy from your word processing program, verifying word count, and paste into box below.

Acknowledgement & Disclaimer:  The CMHS National GAINS Center reserves the right to edit the summary.  Please be clear and concise, the summary will be included in the conference program book.

Narrative (250 word maximum)

Please copy from your word processing program, verifying word, and paste into box below.

Acknowledgement & Disclaimer:  The narrative will be reviewed by the CMHS National GAINS Center staff - staff will base the acceptance of the proposals on the quality and clarity of the presentation narrative and program content as it relates to the conference theme “Creating More Effective Services.”  The narrative will not appear in the conference program book.