KCACTF Region IV

Workshop Proposal Form

Your Last Name
Your First Name
Your School Name
Your Email
Your Phone Number:
Your Cell Number:
Your Fax Number

Workshop Title

(25 words or less, please)
Workshop Description (75 words or less, please)
Target Audience for your workshop
Attendance Limit
List any equipment you need for your workshop but can't bring yourself:
Required Space
Bio for program. You can cut and paste into this box from your word processing program. Please make this print-ready and 100 words or less, please:
Additional Comments or instructions/requests to Workshops Coordinator:
Please select when you would prefer to hold your workshop:  
WEDNESDAY, February 6 Availability
 *required field
THURSDAY, February 7 Availability
 *required field
FRIDAY, February 8 Availability
 *required field
SATURDAY, February 9 Availability
 *required field

If you need to contact the KCACTF Region IV Workshop Coordinator:

Tony Tassa tassaa@pbcc.edu