Proposal Cover Sheet
SSSS Western Region Conference, April 10-13, 2003
The Sexual Body: New Developments in Science, Therapy, and Education

Submission deadline: Nov. 1, 2002

Title__________________________________________________________________________

Principal presenter & degree______________________________________________________

Affiliation_____________________________________________________________________

Address_______________________________________________________________________

Phone_________________  Fax______________  Email________________________________

Other authors/presenters__________________________________________________________

Type of presentation (indicate first & second choice):

Pre-conference workshop  2 hours ___         3 hours ___
Plenary session                  1 hour   ___
Panel discussion                1 hour   ___        90 min. ___
Paper presentation        20-30 min.  ___          45-60 min. ___
Other (please indicate)         _________________________________

Audiovisual request:
The following items are available at no charge if requested now. If not requested now, you will be responsible for locating and renting equipment on your own.

35 mm slide projector ___  Overhead projector ___  Chart stand ___
LCD/Powerpoint (your laptop required) ___     VCR and monitor ____

Conference fees:
All presenters must register and pay conference fees within 14 days of acceptance to be scheduled on the program. Presenters are responsible for their hotel, meal, and transportation costs. Please make your hotel reservation now (800/233-1234) to avoid disappointment.

I agree that if this proposal is accepted I or a qualified substitute will present it. I agree to register for the conference within 14 days of acceptance.  If sent by email, your signature will be assumed.

Signature  ____________________________________ Date  _________________

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