Presentation Submission

Thank you for submitting your presentation for consideration at The Finding Freedom Symposium Conference at the Riviera Hotel and Spa,Palm SpringsJanuary 25-27 2018.

Please Note:We encourage the submission of workshop, entertainment and keynote presentation proposals that strengthen best practices, and bring forward relevant information for best practices in supporting the LGBTQ community with co-occurring disorders. Our intention is to offer a container for discovery and focused discussion to find effective solutions for professionals and their LGBTQ patients.We desire content rich workshops that are research based and are contextually forward thinking.

Our goalis to cultivate a conversation that will lead to clinical,research-based information. We are gathering the dynamic leaders in the field of LGBTQ addiction treatment to spark the conversation.

If your presentation is accepted, you will receive one free full conference registration and hotel accommodation for primary presenter (if not local) for the evening before the presentation. Reimbursement for travel expenses is not provided.

Thank you.

The Finding Freedom Committee

Renee Baribeau,Michael’s House Outreach and Events Coordinator

Renee Sievert, Master Certified Coach

Melissa Stevenson,LMFT, Director Foundations San Diego Outpatient Center

Jillian McCarney,FRN West Coast BD Manager

Paul d'Entremont, Director Michael’s House Outpatient Center

Instructions

Please complete the Presentation Proposal Form in full. The form must be typed, and all applicable information must be filled in for the proposal to be considered. Please save the Presentation Proposal Formunder your name and presentation title, then email the proposal to as an attachment. We look forward to receiving your proposal.

The Presentation Proposal Form is in Microsoft Word .doc format. When you save the document, please save as a Microsoft Word .doc or .docx format only. Other formats will not be accepted. Please attach a current CV or Resume.

Timeline

Your presentation proposal must be received before April 31, 2017

The presentation selection committee will review all presentation proposals and contact you by May 30th, 2017 with an acceptance or rejectionof your presentation proposal. If your presentation proposal is

accepted, you will also receive notification of the dates and times of your presentation at the conference in September. Presenters are requested to be present for the entire conference.

Agreement

This presentation proposal also serves as a presenter agreement. By submitting the completed presentation proposal, you are agreeing to the terms and conditions of the presenter agreement. Should your presentation proposal receive acceptance, you will have the option to refuse participation at that time. Thank you very much for your time, effort and desire to share your knowledge. You may be required to complete a complete additional information upon acceptance, if required for CECs.

Presentation Proposal

Session Information
Presentation Title
(10 word maximum)
Length of
Presentation / 60 Minutes
90 Minutes
Presenter Information as it will appear in the program
Presenter:
If you are co-presenting,
please ask each presenter to complete the top of this form. / Full Name (with credentials):
Title:
Organization:
Address:
Address 2:
City/State:
Phone:
Email Address:
Website:
Contact information in Conference Program / ☐ Yes, you may include my contact information in the conference program
☐ No, please do not include my contact information in the conference program
Registration/Travel / ☐ I am the primary presenter. I understand that I will receive a complimentary conference registration on the day that I’m presenting (if applicable, please ask each of your co-presenters to fill out the Presenter information and bio portion of this form)
☐ I am co-presenter, understand that I will receive a complimentary conference registration on the day that I’m presenting
Resume/CV/photo / ☐ I have attached a resume or curriculum vitae (needed for CE/CME requirements.) Photo needed for website.
Bio: (up to 150 words, for the conference program)
If you are co-presenting, each presenter will be asked to complete the presenter information and bio section of this form. The description and learning objectives can be on the primary presenter’s form
Session Abstract or description
(up to 125 words to be used for conference program) / ** If you are presenting the results of a study, please provide an abstract here
** If you are presenting a workshop, please provide a brief session description here
Session Learning Objectives: (please list 2 -3 learning objectives for the session – for CE requirements) / Attendees will be able to (3-4 learning objectives - suggested action learning verbs are listed below):
(Identify, outline, review, explore, examine…)
  1. Identify
  2. Discuss how
  3. Examine key
  4. Explore
  5. Review

Presentation / If this proposal is accepted, you agree to provide a photograph, one paragraph summary of your presentation, and a 1-2 minute video teaser for your presentation within 30 days of acceptance to the conference. These items will be placed on the conference website and shall remain in effect until the next conference.
A draft of your outline, PPT, and handouts will be due 60 days prior to the conference.
Opportunity for Book Signing / If you are an author, we would like to have your book(s) available at the bookstore. Please list the titles you would like us to order (and publisher information if applicable):
Would you like to conduct a book signing after your session? (If yes, we will follow-up with you regarding coordination. ☐Yes ☐ No Not Applicable.
Reference and Book Suggestions / Please list two or three book titles you would recommend that we have at the bookstore for attendees to purchase for their libraries:
THANK YOU!!!! We look forward to seeing you at the Conference!

Presentation Agreement

Submission of this presentation proposal constitutes an agreement ofthe terms as stated below. You will have the opportunity to refuse the terms of the agreement should your presentation proposal be accepted under terms that are not agreeable to you.

The terms of the agreement are as follows:

Presentation Times:

You will be informed of presentation times upon acceptance of your proposal.

Agreement:

  1. You have agreed to present the material detailed in this presentation proposal and agreement. Your presentation hall will be equipped with a laptop computer running Microsoft PowerPoint software, a wireless remote, an audio connection from the computer to the sound system, a large projection screen with a bright projector, a wireless lavaliere microphone if needed, a speaker’s podium, and drinking water. If you have other needs, please list them here:
  1. If applicable, you have agreed to participate in an informal discussion session and book signing where conference attendees may visit with you;
  2. You have agreed to provide Michael’s House with the right to photograph you, and use your picture, photograph, silhouette and other reproductions of your physical likeness in connection with the conference and advertising of the conference;
  3. You have agreed to provide a personal biography, photograph, one paragraph summary of your presentation, and a 1-2 minute video teaser for your presentation within 30 days of acceptance to the conference. These items will be placed on the conference website and shall remain in effect until the next conference.
  4. You have agreed to provide Michael’s House with the right to record your presentation and make it available to those interested in the content of your presentation.
  5. You have agreed to provide handout information of your presentation by 60 days prior to the first day of the conference. Your handouts will be placed on the conference website for download, and the link shall remain in effect until the next conference;
  6. If applicable, you have agreed to facilitate the communication and agreement between the official conference bookstore and your publisher(s) for the sale of your books, videos, and recordings at the official conference bookstore;
  7. For these services and rights, you will be provided a reservation for a non-smoking room at the conference hotel for each night of the day your presentation is scheduled;
  8. You will be provided a complimentary full conference registration.

Travel Arrangements and Reimbursement:

The conference will reserve your hotel room for the night(s) of your presentation(s). Please reserve additional nights directly with the hotel. Please make your own travel arrangements to ensure that they are convenient for your personal schedule. We would like to recommend you to make reservations as soon as possible to ensure a smooth trip. Reimbursement for travel expenses, other than those listed above, is not available.

Terms and Conditions:

TERMINATION. Presenter and Michael’s House, Inc. may terminate this agreement for any reason with two months written notice.

GOVERNING LAW. This Agreement shall be construed in accordance with the laws of the State of California.

Thank you for agreeing to present at this all-important conference. Your contribution will be important to the goals of the conference.

I have read and agree to the terms stated within this Presenter Agreement:

Please record your electronic signature by inserting a back slash in the front and in the back of your name as follows /Pat Doe/

Name / Date

Please complete the Presentation Proposal Form and save it under your name and presentation title, then email the proposal to as an attachment.

The Presentation Proposal Form is in Microsoft Word .doc format. When you save the document, please save as a Microsoft Word .doc or .docx format only. Other formats will not be accepted.

Renee Baribeau • T 760-464-2138• wwwiLGBTQSymposium.com