Arizona Department of Education

Call for Presenters

Teachers’ Institute – June 12 – 13, 2017

JW Marriott Starr Pass, Tucson, AZ

Breakout Session Presenter Application

Return this form by emailing to the Teachers’ Institute inbox ()

no later than January 30, 2017.

You will be notified by February 15, 2017 if your session has been accepted.

Please fill out this form in its entirety. This information will be used in reviewing
proposals, providing descriptions to participants, and selecting room size.

The Arizona Department of Education(ADE) will not be accepting vendor presentations.

The Arizona Department of Educationcannot endorse any services, products or applications.

Click appropriate box

☐ ADE Presenter ☐ External Presenter

(Registration Fee: $50.00 per day) (Registration: $50.00 for 1 day or $395.00 for 2 or more days)

Strand / Choose an item. /
Brief Session TitleTTitlTitleTiot(Keep itshort)
Please answer the following (200 word maximum)
  1. Session Description

  1. Learning Outcomes for Session

  1. Expected Participant Implementation of Information After Conference

Has this information been presented before? ☐ Yes ☐ No
If so, when, where and at what event?
Presenter Name
ADE Presenters Only
Division / Unit
Title / Organization
Mailing Address
City / State / Zip
E-Mail / Day Time Phone
(include area code)
Cell Phone Number:
Biography (50 words maximum)
Co-Presenter Name
Note: No more than one co-presenter will be permitted.

Target Audience will be (check all that applies):

☐ High School ☐ Junior High ☐ Elementary ☐ Pre-School

Availability

Session Presentations will be on Tuesday, June 13, 2017 only.

The Arizona Department of Education supports research and evidence-based professional learning for adult

learners that includes active engagement. Please check all the methods you will be using during your session.

☐Large group discussion
☐ Writing/journaling
☐ Brainstorming
☐ Small group exercises / ☐ Small group discussion
☐ Creating graphic displays of data, key concepts, plans, etc. / ☐ Directed physical movement (e.g. move to different parts of room, mark choices on posters, etc.)
☐ Panel / ☐ Case study(ies)
☐ Role-playing
☐ Partner exchanges
☐ Other (describe)
☐ ______

Please cite the primary scholars/experts you will be using as the basis for your presentation?

The final session description and presenter biography is due on March 13, 2017and the session materials are due on May 1, 2017in order to be uploaded to the Leading Change webpage and the Guidebook event application.

To ensure all sessions are of top quality and adhere to best practices in adult learning, each presenter will be required to attend atraining to share and brainstorm what engagement techniques will be used in the sessions. You will have a choice of 3 dates.

☐Monday, April 3, 20171:00pm – 3:00pmJefferson location, Room 311

☐Tuesday, April 4, 20171:30pm – 3:30pmCentral location, Room 16-102

☐Friday, April 7, 201710:00am – 12noonCentral location, Room 16-102

Location Addresses:1535 W. Jefferson, Phoenix, 85007

3300 N. Central, Phoenix, 85012

ADE Only - Approved by:

Print Supervisor Name
Signature/Date

Thank you for your submission.

2017 Techers’ Institute
Laura Dudzik, Event Management Administrator
602.364.1851

1 TI Breakout Session Review Form 10.2016