Program Proposal Form

Collaboration in Action:
Promoting Residentially Based Education
The Sixth International Conference on
Residential Colleges and Living/Learning Programs
University of Vermont --- October 15 - 17, 1998 

Please print this form and type on a typewriter, or save as a text file
and complete the form using your favorite word processor.

Primary Contact Person:
(This person will receive all correspondence from Conference organizers.)

Name:

Title:

Department/Program:

Institution:

Address:


Telephone:

Fax:

E-Mail:

Website:

Program Title:
(as you would like it
to appear in publications)

Type of Program:
(workshop, panel discussion,
presentation, etc.)

Please limit presentations to 45 minutes, to allow 15 minutes for questions/discussion.
___Check here if this would be an extended presentation and would require two time slots.

Program Description:

On a separate sheet of paper, please describe the objectives of the program, topics to be addressed, and how the program relates to the conference theme. Please include an abstract (approximately 100 words) that can be used in conference publications.

 Presenter #2

Name:

Title:

Department/Program:

Institution:

Telephone:

E-Mail:

Website:

 Presenter #3

Name:

Title:

Department/Program:

Institution:

Telephone:

E-Mail:

Website:

A/V Equipment Needs:
(Check all that apply):

 ___Overhead ___ TV/VCR ___ Chalkboard ___ Easel

___ Other: _____________________________________________________

___ Unsure of needs at this time.

 Showcase of Programs:

___Check here if you plan like to reserve table space for a display of program materials throughout the conference

Collaboration in Action Proposals
Living/Learning Center
University of Vermont
Burlington, VT 05405-0384

E-Mail: vtconf@granola.uvm.edu
Phone: (802) 656-8362
Fax: (802) 656-0812

Program Proposals must be postmarked by May 1, 1998.

Program selection decisions will be mailed on Monday, May 18th.