Name:

Address: City:

State: Zip:

Phone: Email:

Presenter's School Information:
Name and address of main presenter's school

School:

School Address: City:

State: Zip:

School Phone: Fax:

Name, affiliation and city of all presenters as they are to appear in the program.
(NOTE: We do not have room for job titles, department names, etc., unless it is in lieu of an institution., e.g. Independent Consultant.)

1: 2: 3:

Select ONE for each category:

Type of Presentation:

Lecture
Demonstration
Panel/Discussion
Hands-On

Grade Level:

K-4
5-8
9-10
11-12
College
Other

Grade Level:

Biology
Chemistry
Physics
Earth Science
Physical Science
STS
Environmental
Safety
Research
Inquiry
Pedagogy
Other

PSTA will provide an overhead projector (transparency) and screen in each room.   We have a small room with Apple computers and internet access for presentations that need such facilities.  Presenters are responsible for all other equipment at their own expense.  Presenters may bring their own equipment for use at the Hershey Lodge and Convention Center.

Does your session need to be scheduled in the Apple Computer Room?
Yes
No


Preferred Time Allocation: 
(Please indicate either a morning or afternoon preference.  Provide any notes necessary.)
Morning Session
Afternoon Session




Preferred Day:

Thursday
Friday
No Preference

All rooms are set up in classroom style including tables and chairs.
           
Special Circumstances:  

Need more than 15 minutes setup time
Other, Explain

Other Note to program staff:



Safety Information:
1.  Identify any potential safety hazards associated with your presentation.
2.  What precautions will be taken during the presentation to deal with the hazards and to inform the audience of these hazards?
3.  What safety equipment will be required?  Please indicate provider.



Deadline:  Proposals must be received on or before May 30 to procure room arrangements and AV needs. Confirmations will be sent by July 30.  Late proposals cannot be given special consideration as to time preference.

For questions contact:
Dr. Christine Royce
PSTA Program
PO Box 305
Newburg, PA 17240
717-477-1681
717-477-4046 fax
CARoyce@aol.com

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