Proposal Information
Seventh Annual HBCU Counseling Center Conference
Women and Wellness: The Importance of it All
November 8-10, 2012
Please complete and return by Friday, October 12, 2012. Please type or print information.
1. Title of Paper/Program:
2. Primary Presenter
Name: Degree:
Institution:
TOPIC SUGGESTIONS:Spirituality
Ethics
Physical Health
Career Directions
Student Self-Care
TCH, Alcohol, and Student Use
Co-occurring disorders in women
Mental Health, e.g., depression, anxiety, stress
Dual Roles
Oppression
Trauma
Rape Crisis Counseling
Eating Disorders
LGBTQ Issues
Student Retention
Juggling and Maintaining Positive Health
Aspiring Leaders and Wellness
3. Topic Relevance
How is the topic relevant to mental health among Black women or relevant to Counseling Center Business? Topics should fall within the areas of clinical services, professional issues, administrative issues, and outreach/consultation.
4. Paper/Program Description (Similar to abstract.) Describe the program’s overall content and purpose. This section weighs heavily in the review process.
5. Behavioral Objectives
State the major behavioral objectives for your program. Please provide no more than three objectives. Do not attach a separate sheet.
The attendees should be able to….
Audience (check all that apply.)
□Health Educator□Mental Health Professional
□Administrator□Student
□Other:______
- Presentation Style
This program is offered for consideration as a:
□ Check here if you would like your proposal considered for a poster session display if not selected as a program.
Presenter Information
Seventh Annual HBCU
Counseling Center Conference
Women and Wellness: The Importance of it All
November 8-10, 2012
Please complete and return by Friday, October 12, 2012. Please type or print information.
Title of Paper/Program:
Primary Presenter
Name:______Degree:______
Institution:______
Title:______
Address:______
Daytime
Phone:______Fax:______
Email:______
- Please state your training or experience that establishes your expertise on the proposed topic:
- Education/degree(s)/certification:
- Publications related to topic:
- Academic appointments:
- Involvement in professional organizations:
- Awards/honors received:
Co-Presenter Information
Name:
Degree (s)Date of Degree:
Date of Degree:
Licensed/Certified: Licensed as:
State Licensed:
Number of Years of College/University Counseling Center Experience:
History of Professional Positions:
Other Professional Activities (e.g., teaching, consulting, private practice, etc.)
Current Professional Memberships:
Previous Presentations @ the HBCU Counseling Center Conference
______
The information provided in this section must relate directly to your the presentation topic.
Audio/Visual Requirements
Seventh Annual HBCU
Counseling Center Conference
Women and Wellness: The Importance of it All
November 8-10, 2012
Please complete and return byFriday, October 12, 2012. Please type or print information.
Primary Presenter: ______Telephone Number:______
Program
Title:
□Check here for standard A/V setup (theater style, podium, microphone, overhead projector, 35mm slide projector).
1. Audio Visual Equipment:
□overhead project
□videocassette tape player (playback only) and
monitor ____ ½” VHS ____ ½” Beta _____ ¾”
□flip chart with markers
□LCD Projection (You must provide your own computer)
2. Presenter Handouts:
*Due to CE requirements, handouts must be provided. You must bring at least 25 copies with you.
Submit all forms and for more information or concerns contact:
HBCU MH Conference
Attn: Dr. Yolanda K. H. Bogan
101 Sunshine Manor
Florida Agricultural and Mechanical University
Tallahassee, Florida 32307