ISNR 2011 Conference Oral Submission Form
ORAL PRESENTATION (30 minutes or 60 minutes)
Name of person filling out this form:
Preferred method of contact (please list):
Length of Presentation (30 minutes or 60 minutes):
Please fill in ALL the information below in gray boxes. The boxes will expand to accommodate any amount of
information. Questions? Contact Ann Marie Horvat at firstname.lastname@example.org or (800) 847-4986 or 361-949-1738.
1. Scheduling: Please indicate any day or time restrictions you may have. The Conference Committee
will do their best to accommodate your requests.
2. Equipment Requests: Please check the box for any equipment you will need to make your
presentation. If you do not request the equipment in advance on this form, equipment may not be
available for your talk. Please be sure to mark every item you need. If you need a projector you will
likely need a projector screen as well.
*Slide Projector *Overhead Projector * LCD Projector
*Flipchart w/pad & markers *VHS Player *27” Television Monitor
Other (please type in request)
3. Recording Authorization: Please type in your full name below, authorizing the International Society
for Neurofeedback & Research, ISNR, to sell / release / use for professional development purposes the
electronic copy (visual or audio) of your presentation at their 2011 Conference in Phoenix, AZ.
4. Slide Presentation Authorization: ISNR routinely makes the slides from presentations available to
the attendees following the conference. These slides are only given to attendees and are given in .pdf
format. If you do NOT want your presentation distributed please check this box , otherwise ISNR
will make your slides available.
5. Introduction Information: Please include a sentence or two you’d like us to use as your personal
introduction to our conference attendees. This may include your affiliations, where you are from,
special awards/recognition or areas of expertise.
Continuing Education Information:
1. Learning Objectives: Please list a learning objective for your presentation that completes this
sentence: Based on the content of this presentation, the participant will be able to...
2. Outline: List one or two topics you plan to discuss during your presentation (like a brief agenda)
indicating the approximate amount of time (30 minutes or 60 minutes total) you plan to spend on each