<p> SCSHSA ANNUAL FATHERHOOD/MALE INVOLVEMENT TRAINING CONFERENCE: MAY 4-6, 2017 CALL FOR PAPERS APPLICATION</p><p>Please complete and return this two-page form by MARCH 17, 2017; save changes and email as an attachment to [email protected] OR mail to: SCSHSA Fatherhood/Male Involvement Conference Coordinator, PO Box 7562, North Augusta, SC 29841</p><p>Presenter Information: Name of Lead Presenter: Title: Employer/Business Mailing Address: Email Address Website: </p><p>Co-Presenter Information (if applicable): Co-Presenter Name: NONE Title: Employer/Business Name: Mailing Address: Email Address: Website: Phone Number (please include area code): </p><p>What is the title of your workshop or seminar? (4 words or less): </p><p>Description of Presentation (60 words or less):</p><p>Target Group: </p><p>Description of Handouts Provided by Presenter: </p><p>Training Topics (please check ALL that apply): ADMINISTRATION/MANAGEMENT EARLY CHILDHOOD DEVELOPMENT FAMILY/COMMUNITY PARTNERSHIPS for FAMILY ADVOCATES HEALTH SERVICES – circle one: health mental health nutrition dental DISABILITIES SERVICES ADMINISTRATIVE SUPPORT SERVICES PARENT/MALE INVOLVEMENT for PARENTS TRANSPORTATION FAMILY LITERACY OTHER: Please explain: </p><p>Training Categories (please check ALL that apply): 0-3 (EHS) 3-5 (HS) Migrant/Seasonal Tribal EHS-Child Care Partnerships</p><p>1 Type of Session (please check ONE): WORKSHOP (1.5 hours) If you need additional time, you will need to submit another form for Part 2 for 1.5 hours. </p><p>Preferred day(s)/time(s): Please select all that would work for your schedule. We are trying to fill each room, during each training time, so please select a couple of choices if possible.</p><p>Thursday Morning Thursday Morning- Thursday Afternoon Thursday Afternoon Friday Morning </p><p>Are you willing to present this workshop twice: YES NO</p><p>Primary Language of Presentation (please select ONE): English Spanish </p><p>Suggested Number of Participants (please check ONE): 0-40 41-75 76+</p><p>Preferred Room Set (please check ONE): Theatre/Auditorium Rounds</p><p>Audio/visual (LED projectors only: laptops will not be provided) will be provided by SCSHSA. Any additional request must have prior approval. </p><p>Lead Presenter ONLY: Please provide a brief description of your company or consultant services, including contact information you want conference attendees to have, for the “Presenter Index”: </p><p>Once your proposal has been reviewed, a letter or email of notification will be forwarded to the LEAD PRESENTER. SCSHSA will provide a complementary registration for the LEAD PRESENTER and ONE (1) CO-PRESENTER. Facilitators will be arranged for each workshop. </p><p>2</p>