TLPCA Counseling and Therapy Summit

2023 Call for Proposals

Please fill out the form below to propose your presentation for our Annual Conference. The deadline for submission is Wednesday, March 15, midnight. Thank you for your interest!

2023 Annual Event Call for Proposals

"*" indicates required fields

Step 1 of 2

Presenter Information:

Name of the Primary Presenter:*

First Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone*

Email Address:*

Organization:*

Title of Current Position:*

Photo/Headshot

Accepted file types: jpg, jpeg, pdf, png, Max. file size: 5 MB.

Highest Degree Completed:*

Highest Degree Concentration:*

Clinical Mental Health

Clinical Counseling

Counseling

Counselor Education and Supervision

Counseling Psychology

Marriage and Family

Psychology

Social Work

Other

Name of Highest Degree Institution:*

Are you a student?

Yes

Student Information

Current Degree Concentration:

Clinical Mental Health

Clinical Counseling

Counseling

Counselor Education and Supervision

Counseling Psychology

Marriage and Family

Psychology

Social Work

Other

Name of Institution:

Anticipated Graduation Date:

Additional Information

License Type:

Are you a current member of TLPCA?

Presenters are not required to be members of TLPCA. However, please consider joining to obtain access to member resources and benefits. To join, click here.

Yes

Are you a current member of TNAMFT?

Yes

Presentation Information:

Presenter’s Training Relevant to Topic:*

Does your presentation have co-presenters?

Yes

Please List Co-Presenters:

Click on the + button to the right of the first row if you need to add more than one co-presenter.

FIrst Name

Last Name

Highest Level of Degree Achieved

Major or Field of Study

Licensure Type

Title of Presentation:*

Program Summary:*

In 75 words or less, please describe your presentation (using present or future tense). If your proposal is accepted, this will be the description published in the conference program. Please be sure your description is detailed and representative of your session material. This will ensure that attendees are clear about the content and learning objectives you will be presenting.

Check all that Apply for the Content Areas:

Program Objective #1:

Please provide three (3) measurable learning objectives. These objectives should complete the following sentence: “Following this presentation, participants will be able to identify….utilize…explain…understand….”

Program Objective #2:

Program Objective #3:

Biographical Statement of Presenters:*

In 50 words or less, please provide a brief description of your personal experience(s) as you want to be identified in the conference program. Include your current title, professional affiliations, organizations, and area(s) of expertise.

Biographical Statement of Co-Presenter #1:

Biographical Statement of Co-Presenter #2:

Biographical Statement of Co-Presenter #3:

Biographical Statement of Co-Presenter #4:

Biographical Statement of Co-Presenter #5:

Additional Information & Agreement

Agreement 1:*

I agree that if my presentation is accepted, I must register for the conference. Presenters will be given a discounted rate.*

Agreement 2:*

I agree to provide all information to co-presenters.*

Agreement 3:*

I agree that if my presentation is accepted, at least one qualified individual (i.e., masters level professional) will be in-person at the Summit for the presentation.*

Signature