The Children’s Assessment Center (CAC)

SPEAKER REQUEST FORM

713-986-3553 FAX or

Please fill out this form and return by fax/e-mail two weeks or more prior to the date of the event to The CAC Training Department.

NAME OF AGENCY/GROUP REQUESTING SPEAKER:

CONTACT PERSON/POSITION:

PHONE #: FAX #: E-MAIL:

ADDRESS OF CONTACT PERSON/AGENCY:

REQUESTED TOPIC:

OVERVIEW OF THE CHILDREN’S ASSESSMENT CENTER. (1 hour) / SCHOOLS: Reporting Laws, Dynamics of Child Sexual Abuse and Overview of The Children’s Assessment Center
(1 ½ hours)
OVERVIEW OF THE CHILDREN’S ASSESSMENT CENTER & DYNAMICS OF CHILD SEXUAL ABUSE. (1 ½ - 2 hours) / Law Enforcement: The Children’s Assessment Center and Law Enforcement- A Multi-Disciplinary Team Approach to Childs Sexual Abuse Cases (1-1 ½ hours)
DYNAMICS OF CHILD SEXUAL ABUSE. (1 hour) / FOSTER PARENTS –“PARENTING SEXUALLY ABUSED CHILDREN” (2 – 3 hours)
FORENSIC INTERVIEWING / INTERVIEWING SEXUALLY ABUSED CHILDREN (1 hour) / MANAGING AN EFFECTIVE PUBLIC / PRIVATE PARTNERSHIP (1 ½ hour)
CHILD SEXUAL ABUSE CASE PROCESS / STORY OF MARIANNA (30 minutes-1 hour) / THERAPY & PSYCHOLOGICAL SERVICES OVERVIEW & DYNAMICS OF CHILD SEXUAL ABUSE (1-2 hours)
HOW SEXUAL ABUSE AFFECTS CHILDREN & THEIR FAMILIES. (1 ½ hours) / Behavioral Evidence - Victims (1 1/2 hours)
Mothers, daughters & sexual abuse (1 –2 hours) / Psychological Testing and Tips on Cross Examination in Child Sexual Abuse Cases (1-2 hours)
UNDERSTANDING RECANTS (1 hours) / CREATIVE APPROACHES TO GROUP TREATMENT FOR SEXUAL ABUSE (1-2 hours)
EXPLORING BARRIERS TO DISCLOSURES & STRATEGIES FOR TREATMENT (WITH/WITHOUT CASE STUDY) (1 ½ - 2 hours) / Compassion Fatigue and Burnout For Care Givers
STORY OF A PREFERENTIAL SEX OFFENDER (1 ½ - hours) / SEXUAL abuse Medical Examinations on children (1 hour)
Understanding Sex Offenders (1 ½-2 hours) / CHILD SEXUAL ASSAULT/abuse Medical Examinations & sexually Transmitted Diseases (1 ½ hour)
eFFECTS OF SEXUAL ASSAULT ON cHILDREN / PARENTS:

DATE OF PRESENTATION & TIME: _

Location of Presentation:

LENGTH OF PRESENTATION:

WHO IS THE AUDIENCE COMPOSED OF?

SIZEOFAUDIENCE:

HAVE WE SPOKEN TO GROUP BEFORE? __

WHEN & ON WHAT TOPIC?

WHO SPOKE?

Does your facility have any of the following AUDIO-VISUAL EQUIPMENT?

Overhead Projector / TV/VCR
Power Point Projector / Slide Projector
Lap Top Computer
DO YOU WANT HANDOUTS? ___YES ____NO

(CAC USE ONLY)

Your Speaker(s) will be:

Comments:

Speaker Request E-mailed to D.H.?
Speaker confirmed?
Requester notified?
Power Point & Lap Top Reserved
On Campus? Where:______

The Children’s Assessment Center, 2500 Bolsover, Houston, Texas 77005, 713-986-3530, 713-986-3553-FAX

SR Form 11/2004