Call for Presentations - Prevention Training Services

Name *

First

Last

Email *

Phone *

Current Credentials *

Brief Bio *

Please select all dates that you are available:

ATOD Specific Series- June 11-13
Fall Prevention Conference- October 15-17
Supervision of Prevention Professionals- November 6-7

2) Please select all times you are available June 11-13

ATOD Specific Series

3) Please select all times you are available October 15-17

Fall Prevention Conference

4) Please select all times you are available November 6-7

November 6th 9:00-12:00
November 6th 1:30-4:30
November 7th 9:00-12:00
November 7th 1:30-4:30

Supervision of Prevention Professionals

Workshop Title *

Workshop Description *

Preferred length of workshop *

1 1/2 hrs
3 hrs

Which Prevention Domain does this workshop focus on ? *

1 - Planning and Evaluation
2 - Prevention Education and Service Delivery
3 - Communication
4 - Community Organization
5 - Public Policy and Environmental Change
6 - Professional Growth and Responsibility

What SKILL will the participant learn? *

Objective 1: Upon completing this workshop the participant will be able to do... *

Objective 2: Upon completing this workshop the participant will be able to...

Would you like to add a 2nd workshop option ?

Yes
No

2nd Workshop Title *

2nd Workshop Description *

Preferred length of 2nd workshop *

1 1/2 hrs
3 hrs

Which Prevention Domain does workshop 2 focus on ? *

1 - Planning and Evaluation
2 - Prevention Education and Service Delivery
3 - Communication
4 - Community Organization
5 - Public Policy and Environmental Change
6 - Professional Growth and Responsibility

2nd Workshop-What SKILL will the participant learn? *

2nd Workshop-Objective 1: Upon completing this workshop the participant will be able to do... *

2nd Workshop-Objective 2: Upon completing this workshop the participant will be able to...

Would you like to add a 3rd workshop option ?

Yes
No

3rd Workshop Title *

3rd Workshop Description *

Preferred length of 3rd workshop *

1 1/2 hrs
3 hrs

Which Prevention Domain does workshop 3 focus on ? *

1 - Planning and Evaluation
2 - Prevention Education and Service Delivery
3 - Communication
4 - Community Organization
5 - Public Policy and Environmental Change
6 - Professional Growth and Responsibility

3rd Workshop-What SKILL will the participant learn? *

3rd Workshop-Objective 1: Upon completing this workshop the participant will be able to do... *

3rd Workshop-Objective 2: Upon completing this workshop the participant will be able to...

Will you request an honorarium? *

No
Yes

Honorarium requested: *

( Our typical honorarium rate is $100 per training hour)

Would you like information about connecting with us as an Independent Consultant?

Yes
No

Prevention Training Services has no employees. All presentations and contributions are completed by Independent Consultants and Volunteers.

Questions or Comments

Thank you for your proposal !