Online Form for Education Courses Only

Call for Courses Deadlines, Topic and Details

All fields marked with an * are mandatory.

*Salutation

Ph.D.Mrs.Ms.Mr.Prof.

*Last Name

*First Name

Title

*Company

*Address

*City

*State

*Postal Code

*Country

*Phone

Fax

Cellular Phone/Pager

E-mail

*Brief Biography (used for your introduction prior to presenting)

*Teach a workshop or tutorial

I would like to teach a half-day workshop
I would like to teach a full-day tutorial

*Workshop/Tutorial title

*Course Description (not to exceed 150 words)

What You Will Learn (Bullet the topics that will be covered in your course not, to exceed 25 words)

Who Will Benefit (The audience this course would best suit, not to exceed 25 words)

Please include any additional information in this block; i.e. Name, phone, e-mail of your marketing agent or alternate contact you would prefer us to use.

I am not interested in presenting but please send me attendee information.

Professional Development Due Dates
Proposals due:	July 18, 2008
Acceptance by:	August 29, 2008
Workbooks due:	January 16, 2009

If you do not receive a confirmation e-mail from Michelle Michelotti within 2 business days,
please e-mail her at MichelleMichelotti@ipc.org