Request for Workshop Proposals Step 1 of 4 25% It is HIGHLY recommended that you use the Workshop Proposal Worksheet to gather the requested information prior to beginning this online form. However, there is an option to Save and Continue Later if you find you don't have all the necessary information to submit your proposal. When you click SUBMIT at the end of the form, a thank you page will display a summary of your answers. This information will also be included in the confirmation email you receive.Workshop Title & Contact1. Workshop Title*Titles can be no more than 96 characters.2. Proposal Contact*This is the person submitting the proposal. If you will also be one of the presenters, you MUST include yourself in the presenter list below. First Name Last Name Phone Agency Name Email Address* Enter Email Confirm Email Continuing EducationAs a provider of continuing education credits, ACLAIMH complies with all policies and guidelines set forth by the licensing/credentialing entity. Therefore, we are required to collect specific information on sessions and presenters that may provide continuing education contact hours.SessionsWorkshops offering credit must have a description of the content, as well as THREE (3) Learning Objectives.PresentersFor each presenter of a workshop offering credit, we must have the following:Concise biography in paragraph formatResume or CVDigital head shot ACCREDITATION STATEMENTS NYS Licensed Social WorkersThe Association of Community Living Agencies in Mental Health, Inc. (ACLAIMH), SW CPE is recognized by the New York State Education Department’s State Board for Social Work as an approved provider of continuing education for licensed social workers #0281. CASAC/CPP/CPSThe Association of Community Living Agencies in Mental Health, Inc. (ACLAIMH) is recognized by New York State Office of Alcoholism and Substance Abuse Services (OASAS) Education and Training – Provider Certification Number 1214. Training under a New York State OASAS Provider Certification is acceptable for meeting all or part of the CASAC/CPP/CPS education and training requirements. NYS Licensed Mental Health CounselorsAssociation of Community Living Agencies In Mental Health, Inc. (ACLAIMH) is recognized by the New York State Education Department's State Board for Mental Health Practitioners as an approved provider of continuing education for licensed mental health counselors. #MHC-0069. 3. Are you seeking to offer CE contact hours?*Please select each type of CE credit that applies to your workshop. ACLAIMH will determine if your proposal meets the criteria set-forth by the credentialing entity. LCSW/LMSW CASAC/CPP/CPS LMHC Not seeking to offer CE contact hours In addition to the information entered through this online submission form, CE credit courses must also complete the following forms and return them to the ACLAIMH Events Department at email@example.com. Course Information Form - One form is required per workshop.Instructor Qualifications Form - A form is required for each presenter. Save and Continue Later Workshop Information4. CategorySelect all that apply. Housing Models/Development Administrative Partnering Recovery/Employment Clinical Other Other*Please provide a category for your workshop5. Workshop Description*Please provide a concise, narrative description of your presentation, as you would like it to appear in conference publications. Be sure to include any information about planned involvement of workshop participants or the benefits your workshop might provide for participants. (ACLAIMH reserves the right to edit descriptions as necessary.)5. Workshop Description*Please provide a concise, narrative description of your presentation, as you would like it to appear in conference publications. Be sure to include any information about planned involvement of workshop participants or the benefits your workshop might provide for participants. (ACLAIMH reserves the right to edit descriptions as necessary.)CE Credit Sessions: Learning objectives should not be included here. Please enter those in the next field.5a. Workshop Learning Objectives*Please list THREE (3) learning objectives for participants. Put each objective on a separate line. (This is in addition to the workshop description, and is required for sessions offering CE Hours.)6. Target AudienceWho is your presentation best suited for? Select all that apply. Administrators Direct Care Staff Finance Staff Human Resources Staff QA Staff Supervisors Other Other*Please list your target audience segment. Save and Continue Later Presenter Information7. Presenter List*Enter each presenter's name exactly as it should appear in conference publications, along with the other information requested. To add additional presenters, click the plus sign at the end of the row. (Be sure to include the Primary Contact if they will be presenting.) *Required fields are noted with an asterisk.Full Name*DesignationAgency/ Company*Job Title*Email Address*Biography* 8. Presenter Head ShotsWe request a head shot for each presenter in your group. Files should be at least 300 px x 300 px, and in one of the following formats: JPEG, PNG, TIFF. Drop files here or Accepted file types: jpg, jpeg, tif, tiff, png. 9. Presenter ResumesIf you are seeking to offer CE hours, we MUST have a resume or CV on file for each presenter in your group. (This is in addition to the biography provided above.) Drop files here or Accepted file types: pdf, doc, docx. 10. Have you, or anyone in your group, presented at a conference of this type before?YesNo10a. Please list the topics you have presented on at this, or any other conference:* Save and Continue Later Workshop Logistics11. Length of Presentation*Workshops are scheduled in 90-minute time slots.1.5 hours (One Part)3.0 hours (Two Parts)12. Presentation FormatAll workshop rooms are set-up with laptops, projectors and screens; seating is configured to hold the maximum number of participants for all sessions and cannot be altered for an individual presentation. Select all that apply. PowerPoint Presentation/Lecture Interactive Group Activities Other Other*Please describe your presentation format.13. Presentation Time - FIRST CHOICE*Select your FIRST CHOICE from the drop down list below.No PreferenceWednesday AfternoonThursday MorningThursday AfternoonFriday Morning13a. Presentation Time - SECOND CHOICE*Select your SECOND CHOICE from the drop down list below.Wednesday AfternoonThursday MorningThursday AfternoonFriday Morning13b. Presentation Time - THIRD CHOICE*Select your THIRD CHOICE from the drop down list below.Wednesday AfternoonThursday MorningThursday AfternoonFriday Morning14. AV EquipmentAll workshop rooms will be pre-set with a Screen, LCD Projector, Slide Remote and Laptop running PowerPoint 2010, PowerPoint 2013 or PowerPoint Viewer. Larger rooms will also have a podium microphone available; smaller rooms do not need microphones. Please list any additional AV equipment you will need from ACLAIMH. FINAL NOTES: All presenters will be notified by the end of JULY via email regarding the status of their proposal. If your presentation is chosen, ACLAIMH will contact you to review the information provided here, as well as provide a list of specific deadlines and file requirements. All presentations and handouts must be submitted to ACLAIMH (1) week prior to the conference. These materials will be provided electronically through our Mobile App. All presenters must register for the conference and overnight accommodations on their own. A discounted conference fee will be available for presenters planning to attend the entire event. ACLAIMH cannot provide honoraria or travel reimbursement for presenters. The Conference Committee reserves the right to request a modification of the proposed content, which may include asking presenters to combine similar presentations. CommentsThis field is for validation purposes and should be left unchanged. Save and Continue Later This iframe contains the logic required to handle AJAX powered Gravity Forms.