TransOhio Tenth Annual Transgender and Ally Symposium Workshop Proposal Form

April 27- 29,2018 - Ohio State University Student Union

(Please submit form typed for clarity purposes- Please do not change or alter forms to make it easier for those reviewing the proposals. Please complete all necessary parts of forms and include needed materials along with the fully completed proposal form- Thank you!)

1.Preferred Name:

2. Email Address:

3. Phone Number for contact:

4. Title of Workshop:

5. Brief description of the workshop(3-4 sentences)

5. Target audience for this workshop and note if closed access desired:

6. Is this workshop for Providers day involving continuing education credits (Circle one) Yes No

(Note: If submitting for providers day, please attach a summary of the key concepts or learning points of the workshop/ objectives to be met by same as well as a copy of your resume or CV- BOTH REQUIRED) The program will be submitted for various accreditation for CEU’s with several organizations.

7. If to be presented on Providers Day, do you also wish to present this workshop at general symposium on Saturday or Sunday? Yes No

8. If desiring to present during general symposium either exclusively or as a repeat of Providers Day workshop, please note any preference on days

Sat. Sun or Eitheris fine

9. A/V available includes hookup to LED projector, LED projector and any flip charts and markers needed in each room. You must bring your own computer, laptop PowerPoint presentation. Internet access is available throughout the facility. (Please note that the facility has had issues with hookups to some Apple or Mac products in past. It is recommended that you also bring a copy of any presentation on a flash drive as well. Are there any other special A/V needs? Please list:

Note: It is recommended you bring along any dongles or adapters needed although we will have a limited supply of the same available.

Please note any other special needs or specific restrictions of time of presentation if needed:

If you are submitting more than one workshop and we are not able to fully accommodate every proposal, please rank your preference each specific workshop proposal in order of preference (1, 2, 3 etc.) Ranking for this workshop proposal if applicable:

Submit proposal for workshop to:

Melissa Alexander at TransOhio, Inc.

Email address: or by mail to P.O. Box 14481 Columbus, OH 43214

NOTE: Proposals submitted by February 23, 2018 will be given priority and those submitted after deadline will be considered ONLYif space is available and no submission can take place after program is submitted for publication around April 5, 2018.