* Name:
* Professional Title:
* Organization:
* Address:
* City:
* Zip Code:
* Phone Number:
* Email Address:

* Presentation or Workshop Title:

* Topic of Presentation or Workshop:

* Provide us with a short description of your Presentation or Workshop:

* Possible Learning Outcomes:

* How will the presenter/facilitator engage students?


* Do you need access to a projector for a Powerpoint presentation?
Yes No
* Does your presentation require to be outdoors?
Yes No

* Which locations will you present at:
Northern Idaho
Magic Valley
Eastern Idaho
Treasure Valley
All Locations

* What time would you like to present?:
9:00 AM
10:00 AM
11:00 AM
All Three Times

Will anyone be joining you for your presentation or workshop and joining us for lunch?
* How many?(Please enter 0 if none):

* Please add each co-presenter's name (100 words or less):

* Please add a short bio about yourself (200 words or less):

Please email a photo of yourself to use in the program to lymaris.ortizperez@icha.idaho.gov

* Required fields