Columbus State Student Leadership Conference 2013 workshop and presentation application
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This document is a workshop and presentation application form for the 2013 Collegiate Leadership Conference of Ohio (CLCO). The conference theme is "A Leader's Legacy: Making History Every Day" and will focus on developing leadership skills, building professional networks, and civic engagement. Applicants are asked to provide details about their proposed workshop such as the title, presenters, goals, outline, equipment needs and intended audience. The deadline to apply is September 27, 2013. Workshops can be single or double sessions and held on Friday evening or Saturday morning/afternoon.
Columbus State Student Leadership Conference 2013 workshop and presentation application
- 1. CLCO 2013 Workshop and presentation application form 1 A Leader’s Legacy: Making history every day 2013 Collegiate Leadership Conference of Ohio Workshops and Presentation Application This year, Student Engagement and Leadership (SEaL) will commemorate Columbus State’s 50th Anniversary by empowering the next generation of college students to develop their leadership skills, construct a professional network, and make a difference through civic and community engagement. This year’s conference, “A Leader’s Legacy: Making History Every Day” will engage students through workshops (including a special track for “First Generation” college students), keynote speakers and community service projects. The conference will encourage college students to make history every day by investing themselves in the world around them and by actively participating in their own leadership evolution. Application Deadline: September 27, 2013 Presenter Information Workshop Title: Co-‐presenter(s) if Applicable Co-‐presenter 1 – Name: Title: Institution/Organization Name: Email: (All communication from the Planning Committee will go to this address.) Address: State: Phone: City: Zip: Fax: City: Co-‐Presenter 1 Bio Please provide us with a short bio with which this presenter would like workshop hosts to introduce her or him:
- 2. CLCO 2013 Workshop and presentation application form 2 Co-‐presenter 2 – Name: Title: Institution/Organization Name: Email: (All communication from the Planning Committee will go to this address.) Address: State: Phone: City: Zip: Fax: Co-‐Presenter 2 Bio Please provide us with a short bio with which this presenter would like workshop hosts to introduce her or him: Co-‐presenter 3 – Name: Title: Institution/Organization Name: Email: (All communication from the Planning Committee will go to this address.) Address: State: Phone: City: Zip: Fax: Co-‐Presenter 3 Bio Please provide us with a short bio with which this presenter would like workshop hosts to introduce her or him:
- 3. CLCO 2013 Workshop and presentation application form 3 A Leader’s Legacy: Making history every day Workshop Information Workshop Title: Presenters: Abstract -‐-‐ REQUIRED Please provide a 50-‐word abstract of your workshop to be used in conference materials (CLCO reserves the right to edit as needed): Workshop Goals and Learning Outcomes Please provide an outline of your workshop's goals and learning objectives. Workshop Outline Please describe how your workshop will achieve the above stated goals and how participants will be actively engaged. Workshop Focus Please indicate which focus best describes your workshop. Leadership Skills Constructing a Professional Network Making a Difference through Civic and Community Engagement The Evolution of a Leader First Generation College Students: Blazing a New Trail
- 4. CLCO 2013 Workshop and presentation application form 4 Conference Theme Please describe how your workshop relates to the CLCO 2013 theme –A Leader’s Legacy: Making history every day Other: If your presentation or workshop does not fall into any of the above categories, please include a brief description of your focus below. Length and Time of Workshop Workshop Length Single Session (50 minutes) Double Session (110 minutes) (only offered on Saturday) Preferred Time Please indicate your preferred time to present. Please note that preferences will be given based on date of proposal submission. Friday evening Saturday morning Saturday Afternoon Are you willing to deliver this workshop more than once? Yes No Audience Preferences Target Audience Please check all that apply. Advisors Emerging Leaders First Generation College Students Programming Boards Fraternity/Sorority Members Student Government Members Residence Hall Students Community Members Other (Please specify) Audience Size We know that some workshops are geared to a larger audience and others require a smaller group. To facilitate room assignments, please indicate your intended audience size. Please check all that apply. 10-‐20 20-‐30 30-‐40 40-‐50 Audio Visual Equipment A/V Requests
- 5. CLCO 2013 Workshop and presentation application form 5 Please indicate your A/V needs below. This includes electronic needs as well as hard materials such as flip charts and markers. NOTE: All rooms are equipped with PCs and projectors. If you plan to use your own laptop or a flash drive, please indicate below and please allow time to set up before your presentation. (Mac users, please provide your own adaptors). Agreement NOTE: Each presenter must sign the following: Photo Release -‐-‐ REQUIRED All presenters are asked to agree to the following: I hereby give the Student Ambassador Leadership Program the absolute right and permission to copyright, publish or use photographs of media which may be included in whole or in part or composite or distorted in character or form, in conjunction with my own or fictitious name, or reproductions thereof in color or otherwise, made through any media that SALP chooses or hires someone to create and/or reproduce, for art, advertising, use on SALP or Columbus State website, in publications, trade or any other lawful purpose whatsoever. I hereby waive my right to inspect, and/or approve the finished product of the advertising copy that may be used in connection therewith, or the use to which it may be applied. I have likewise communicated this photo release information to all of my co-‐ presenters, if applicable, and attest that they have also agreed to its terms. I am 18 years of age or older and I am competent to contract in my own name. I have read this release before signing below and I fully understand the contents, meaning and impact of this release. NOTE: Anyone under the age of 18 must have a parent or guardian sign this form, and indicate below: I give my child permission to participate and agree to the terms listed above. Yes/No Electronic Signature -‐-‐ Please Type Full Name By typing or signing your name below, you acknowledge that you have read and understood the photo release above, that if selected you will present this workshop at the Columbus State Leadership Conference, that all presenters and co-‐presenters must register for the conference by October (CSCC faculty and staff exempt), that you understand that Columbus State does not provide stipends, honoraria, or travel expenses to presenters, and that all co-‐presenters (if applicable) have seen and agreed to these terms. Name: Date: Please type in the date of submission and electronic signature.