ERAPPA Presentation Submission Form

Terms and Conditions*

By submitting this form, the writer acknowledges (s)he understands that in order to present at the conference (s)he must be registered as a PAID ATTENDEE to the conference: *

Yes
No

Presenter Information *

Title:*

First Name:*

Last Name:*

Institution/Organization*

Position:*

Address:*

City:*

Country:*

State*

Province*

Other*

Postal/ZIP Code:*

Work Phone:*

Please use dashes

Fax (Optional):

Please use dashes

Email*

Enter Email Confirm Email

Has presenter previously submitted to present, or been chosen to present at ERAPPA?*

Co-Presenter Information (Not Required)

Co-Presenter Title:

Co-Presenter First Name:

Co-Presenter Last Name:

Co-Presenter Position:

Co-Presenter Institution/Organization:

Co-Presenter Country:

Co-Presenter State

Co-Presenter Province

Co-Presenter Other

Co-Presenter Address:

Co-Presenter City:

Co-Presenter Postal/Zip Code:

Co-Presenter Work Phone:

*Please use dashes

Co-Presenter Fax:

*Please use dashes

Co-Presenter Email:

Presentation Information * (Required)

Presentation Title:*

Please enter at least four learning objectives (This will be used to obtain approval for AIA LU/PDH credits and is a mandatory requirement):*

Educational Track*

Please enter a short abstract:*

Give the brief biography of your qualifications:*

Please list two references of people for each presenter who are familiar with your presentation material or skills.

Reference 1 Full Name:*

Reference 1 Email:*

Reference 1 Phone:*

Reference 2 Full Name:*

Reference 2 Email:*

Reference 2 Phone:*

Other Information * (Required)

Any other information you feel the committee may want to know. Please list additional presenters here listing their title, institution/organization, and email:*

Preference may be given to presentations that qualify for continuing education units (CEU's).

Does this presentation qualify for:*

AIA Credit?

Professional Engineer Professional Development Hours?*

Green Building Certification Institute, LEED Professional Credential Maintenance Program Credits?*

Code Enforcement Official Continuing Education?*

If this presentation has not yet qualified for continuing education units (CEU’s), where applicable, would the presenter be willing to work with the conference education committee to pursue certification? In general this means the final presentation must be available to the reviewing authority prior to May 15, 2019.*

Yes
No

Is the presenter willing to have their presentation posted on ERAPPA’s website:*

Yes
No

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