CALL FOR PROGRAMS
(Submission Deadline 01/20/2012)
KANSAS COUNSELING ASSOCIATION CONVENTION
'A CAPITAL EVENT'
MARCH 8-9, 2012
CAPITOL PLAZA HOTEL
TOPEKA, KANSAS
All presenters
must register
for the
Conference
1st Presenter*
2nd Presenter*
Home Address
Contact Numbers
(home/cell/work/email)
Presentation Title
Program Description
(30 words or less) to be
used in program. Address
how your program can
benefit mental health and
school counseling.
Interest Area
for Program
Elementary
Private Practice/
Mental Health
High School
Middle School
Post-Secondary
Which Division does the
program represent?
AV Equipment
All Audio Video Equipment will need to be brought by the presenter(s).
There will also be no Internet available, please make other arrangements
prior to presentation. (i.e. Mobile Hotspot, WiFi stick, etc.)
Credentials of Presenter
MS
PhD
NCC
LPC
LCPC
other (please list):
Form will be sent to the listed address
by clicking Submit button
William Skaggs, MS, LPC
4408 SE Michigan Ave
Topeka, KS 66609
williamskaggs3@yahoo.com