Proposed title for the session::

Description of the Session:
(Please provide a 30-50 word description of the session, highlighting the program's appeal to WVLA Conference attendees. If your program is chosen, this description will be edited and used in the conference program.)

 Intended Audience: (check all that apply)
Academic
Public
School
Special
Trustee/Friends
All

Format of Program: (check one)
Single speaker
Panel presentation
Demonstration
Other - please describe

Costs for this program:

Audiovisual/technology needed for this program:

PERSONAL INFO:    TITLE:  MR.  MS.  MRS.  MISS  DR.

FIRST NAME

LAST NAME
 

HOME ADDRESS

CITY STATE  ZIP 

 HOME PHONE 

WORK INFO:

 POSITION

ORGANIZATION

WORK ADDRESS

CITY STATE  ZIP 

 PHONE  FAX 

 E-MAIL    (required)

Are you going to be one of the presenters? yes  no

Please list additional presenters, their affiliations, and contact information:

Are you willing to be the host/contact for this session?  yes  no