Conference Contributor Summary

Thank you for taking the time to complete this form. This information is imperative to our conference planning. Items with red asterisks indicates a required item. This form also offers you the ability to save and continue if you need to come back to complete it. If you have any questions about and/or issues completing this form, please feel free to contact MGA at (586) 996-3456 or admin@michiganguardianship.org

Contact Us

X/Twitter - This field is for validation purposes and should be left unchanged.

Please provide your name as you would like it to appear on event materials.

Last Name

Title - Please provide your title or any accreditation as you would like it to appear on event materials.

Name of entity you work for - Please provide the name of the entity you work for as you would like it to appear on printed materials and items promoting your session.

Office Address:

Street Address

Address Line 2

City

State / Province / Region

ZIP / Postal Code

Email

Cell Phone Number - Please provide MGA with your cell phone number for contact. Please note that this number will not be shared and is only for the association administrators use for conference day contact if needed..

Speaker Headshot - Accepted file types: jpg, png, Max. file size: 2 GB.

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Presentation Title - Please provide the title of your presentation as you would like it to appear on printed material, event advertisements and the MGA Website.

Small Speaker Biography - Please provide a biography as you would like it to appear on printed material, event advertisements and the MGA website. Please note that you can provide as large a biography as you like, but it may be edited depending on the application.

Small description of your presentation - Please provide a description your presentation as you would like it to appear on printed material, event advertisements and the MGA website.

Point of Reference - Please check the point of reference for this presentation. Please note that you make choose more than one.

Theories and concepts of human behavior in the social environment

Social work practice, knowledge and skills

Social work research, program evaluation, or practice evaluation

Social work agency management or administration

Development, evaluation, or implementation of social policy

Social work ethics and standards of professional practice

Current issues in clinical or macro social work practice

Cultural competence and diversity

Pain/Pain Symptom Management-Psychology of Pain

Bibliography - One reference for each hour of presentation. If citing one reference it must be current within the last 5 years. References must be listed in APA format. References must be from a peer review book or journal. Websites may be listed as a fourth reference only if it the direct link to the topic being presented.

Presentation Objectives - Presentation Objectives will be scored on the Attendee Survey, please make presentation objectives different than presentation description. Thank you!

Resume and/or Curriculum Vitae - Accepted file types: pdf, xlsx, doc, docx, xls, jpg, Max. file size: 2 GB.

Upload File

Please, upload any handouts you would like provided to the conference attendees. - Accepted file types: pdf, xlsx, doc, docx, xls, jpg, Max. file size: 2 GB.

Upload File

Release of Liability - I herby certify that to the best of my knowledge that my presentation does not violate any proprietary or personal rights of others, including any copyright, trademark and/or privacy rights. I also certify that my presentation is factually accurate and contains nothing defamatory or otherwise unlawful.

Yes, I certify the above is true to the best of my knowledge.

Permission to Publish and Distribute - I understand that MGA presenters are recognized in the registration and on-site program booklets and are promoted prior to and after the conference to many different individuals, companies, organizations and agencies. I herby permit the Michigan Guardianship Association to publish and distribute my presentation materials at it sees fit. Not limited to the MGA website, MGA Facebook page, printed materials and electronic distribution.

Yes, I provide my permission.

No, I ask that my presentation materials not be shared with persons not attending the Conference.

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586-996-3456

admin@michiganguardianship.org

P.O. Box 575

Monroe, MI 48161

Michigan Guardianship Association