7th Annual Honestly Autism Day

April 16, 2016 – Radison Hotel, Timonium, MD

Call for Papers – Proposal Submission Form

DEADLINE FOR ALL PROPOSAL SUBMISSIONS – December16, 2015

Title of Presentation (10 word maximum)
Abstract (50 word maximum, appropriate for inclusion in published conference materials)
Learner Objectives(Include three learner objectives to be addressed through this presentation.)
Description (Please provide sufficient information in your description to clearly explain to the reviewers
what your presentation will address. Do not simply include an outline, but rather write in
narrative form. (300 word maximum)
Bibliography(Please list references that are relevant to the content of the presentation.)
Target Audience(Highlightthe audience group(s )for whom you feel this session isMOSTappropriate. It is extremely important that your presentation be aligned with the audience you select below so that attendees are not misled. PLEASE ONLY HIGHLIGHT THE SPECIFIC AUDIENCE TARGETED.)
Educator – Beginner
Educator – Advanced
Families/Parents/Caregiver
Related Service Providers (Occupational Therapists, Physical Therapists, Speech Therapists…)
Social Workers/Counselors/Psychologists
School Administrators
Other (write in)
Target Audience Cont.(Highlight one or as many age groups your session will address.)
My session will target issues related to the following:
Newly Diagnosed
Early Childhood
Childhood
Adolescence
Teen
Transition
Adulthood
Other (write in)
Presenter Name(s) and Affiliation(s) (Please list your name and credentials as you would like
them to appear in the program.)
Contact information (Please list the name, address, telephone, fax and email of the contact person for
this session.)
BriefBiography(Please provide a short biography for each presenter. (30 word maximum for each
presenter)
Past Presentations(List 1-3 recent related presentations/publications by presenter(s).)
Format Pleasedescribe the format of your presentation. If it is not the typical lecture format, please be as descriptive as possible so the reviewers have a good idea of your vision. (Some possible formats would be lecture, panel, roundtable discussion, or workshop with hands on activities.) Explain the kind of interaction, if any, there will be between the speaker(s) and the participants.
AudioVisual / Other Requirements-Please highlight what you will need provided. If you will be bringing your own laptop and/or projector please DO NOT highlight those items. The HAD committee greatly appreciates those who have access to and areable to bring their own LCD projector and/or laptop. (We will provide the set-up and will have backups available if you are bringing your own equipment.) Microphones will be utilized based on the attendance and size of the individual breakout session.
  • LCD Projector
  • Laptop
  • Internet access for presentation
  • Speakers
  • Table for presentation materials
  • Podium
  • Other ( Write in)

Recording(Please indicate whether you would be willing to have your session recorded. Please be sure to
check with all of your presenters before answering.)
Handouts- It is extremely important that all handouts are submitted by the deadline. Handouts can be emailed or faxed to Debbie Page or fax 410-583-8736. The deadline for receipt of handouts is March 16, 2016.
(Please indicate below whether or not you will have handouts for your session)
Agreement– By submitting this proposal, I agree to abide by all policies and regulations as outlined above. I agree to present at any time during the conference at which my presentation is scheduled. I understand that not presenting at the agreed time and date may result in my not being invited to present at future conferences. I understand that no payment is given for presentation(s), nor is there reimbursement for related expenses.
(Highlight one) I agree I disagree
Full name:
Notification You will be notified in February 2016 as to the status of your proposal.

Thank you for your commitment to participate in Honestly Autism Day 2016.

Your experience, expertise and willingness to share with others are what make our event a success.

Autism Society of Baltimore-Chesapeake