Header Left

Conference Proposal Submission Form

SUBMISSION DEADLINE: March 18, 2012

Please complete the four sections of this form and then
click Next to verify the form data before finally submitting it.
You will be able to add a co-presenter after verifying and submitting the form data.


Section I: Please enter the information for the principal (presenting) author.
Title:
*First Name:
Middle Inital:
*Last Name:
Principal Author's Job Position:
*Highest Degree earned:
*Membership Status:
Join PJSA Now!
*Brief Biography:
(limited to 75 words)


Section II: Please enter the complete mailing address for the principal (presenting) author.
*Address Type:
*Address Line 1:
Address Line 2:
Address Line 3:
City:
State or Province:
Zip or Postal Code:
*Country:
Office Telephone:
Home Telephone:
Fax:
*Enter your preferred email:
*Re-enter Email:
Personal Website, enter URL after http://


Section III: Institutional/Company Information.
*Institutional/Company Affiliation:
*City:
State or Province:
*Country:
Institutional Website, enter URL after http://


Section IV: Please enter the proposal information.
*Preferred Mode of Presentation:
*Presentation Title:
Select the dates that you prefer to present:
(check all that apply)
A/V requested:
(check all that apply)
Additional requests:
*Summary of Presentation:
(limited to 150 words)
*If this proposal is accepted, do you want this summary to be automatically posted to the PJSA website for electronic archiving?
*If this proposal is accepted, will you allow for your presentation to be audio or video-taped?
*What are your paper plans?
Today's Date:
After clicking Next, please allow 10 seconds for the page to load.
* denotes required field