2017 WATERJAM WORKSHOP PROPOSAL FORM
SUBMITTAL DEADLINE: MARCH 24, 2017 to Noelle Slater ()
The WaterJAM Technical Program Committee is soliciting proposals for conference workshops at the 2017 VA-AWWA/VWEA WaterJAM Conference (September 11-14, 2017) in Hampton. In order to be considered, this form must be completed and submitted by the Chair of the proposing VA-AWWA/VWEA committee by the specified deadline. Proposals will be reviewed by the WaterJAM Technical Program Committee for technical content, industry relevance, speaker demographics, and breadth of viewpoint. Please note that workshop room availability is limited. The listed Workshop Coordinator will be notified via email regarding acceptance status. Please contact Noelle Slater with questions.
Activity / DateWorkshop proposals due to Technical Program Committee () / March 24, 2017
Notification of Workshop acceptance (workshop coordinator notified by email) / April 7, 2017
Deadline for Workshop cancellation (workshop coordinator to notify Noelle Slater) / August 28, 2017
If you wish to seek continuing education credits for water and/or wastewater operators, the following must be attached for each proposed Workshop speaker:
· Presentation abstract (maximum of 300 words).
· Speaker contact information
· Brief speaker bio
Title of Workshop: ______
Name of Proposing VA-AWWA or VWEA Committee: _
Name of VA-AWWA or VWEA Committee Chair: _
Preferred Time: Monday (full day) Monday (half day) Thursday (half day)
Target Audience (check all that apply):
2017 WaterJAM Workshop Proposal Form 1
Utility Managers
Utility Operations Personnel
Utility Maintenance Personnel
Design Engineers/Consultants
Regulators/Government Officials
Other (Please List) ______
2017 WaterJAM Workshop Proposal Form 1
Maximum number of anticipated attendees (needed for room sizing): _____
Room Setting: Classroom (w/desk) Classroom (w/o desk) Round Tables
Audio Visual Equipment and Onsite Needs:
LCD Projector and Screen Other (Please Specify)
Food & Beverage:
Breakfast Lunch Notes:______
Please email this form when completed to Stacey Higgins () and Beverly Noffsinger () for arrangement of room setup, food and AV needs.
Workshop Coordinator (main point of contact):
Name: _
Title: _
Affiliation: _
Address: _
City: _
State: _
Zip: _
Primary Phone: _
Fax: _
Email: _
Workshop Speakers/Presenters:
2017 WaterJAM Workshop Proposal Form 1
Name:
Affiliation:
Speaker Confirmed?
Name:
Affiliation:
Speaker Confirmed?
Name:
Affiliation:
Speaker Confirmed?
Name:
Affiliation:
Speaker Confirmed?
Name:
Affiliation:
Speaker Confirmed?
Name:
Affiliation:
Speaker Confirmed?
2017 WaterJAM Workshop Proposal Form 1
Workshop Detailed Description: (Attach additional sheets if necessary)
Workshop Learning Objectives:
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2
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2017 WaterJAM Workshop Proposal Form 1