If you are a human and are seeing this field, please leave it blank. Fields marked with a * are required. First Name * Last Name * Institution / Organization * Phone * Email * Education Level * Master'sDoctorate Credentials * Counseling or Mental Health Related * YesNo Biosketch * (<100 words) including past presentation experience Presentation Title * Program Abstract * Learning Objectives (one to three would be appropriate for most presentations) * 1. ___ 2. ___ 3. ___ Presentation Length (can indicate more than one if appropriate): * 90 minutes120 minutes Equipment Needed: Please note any equipment or materials needed for your workshop (note: some materials may need to be provided by presenter) A/V EQUIPMENT / INTERNET CONNECTIONS: No A/V equipment or internet access will be available during the retreat.