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Conference Proposal Submission Form

SUBMISSION DEADLINE EXTENDED to April 16, 2010

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:
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*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:
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