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Keynote CE Form
Keynote Speaker CE Form
Thank you for agreeing to present at the 2025 Fall Conference and Symposium,
"Love and Conflict in Families and Groups; How Relationship Forces Shape Human Behavior"
taking place on October 17 and 18, 2025. Information must be submitted by
July 8
. The following information is required in order to fulfill requirements set forth by our co-sponsors.
Name
(Required)
Please write your professional name, including post-nominal initials that represent your qualifications and credentials. The name submitted on this form will be listed as it is written in all conference related materials.
First
Last
Suffix
Email
(Required)
Phone
(Required)
Keynote Speaker Bio
(Required)
Please provide a brief bio of
no more than 150 words
. This will be used in conference related materials.
Title of Friday Presentation
(Required)
Friday Presentation Summary
(Required)
Please provide a brief description of your presentation's central theme and content that
does not exceed more than 300 words.
Title of Saturday Presentation
(Required)
Saturday Presentation Summary
(Required)
Please provide a brief description of your presentation's central theme and content that
does not exceed more than 300 words.
Post-Test Question
Please provide two simple multiple choice question (with four possible answers) that address the main theme of each presentation.
The correct answer must be included with each question.
Questions provided by presenters will be used in a post-test to be included in the conference evaluation form given to PA social workers, LPC's and LMFT's who participate by watching the zoom recording, and who need CE credits for doing so. This is a requirement set forth by our co-sponsor.
[Friday Presentation] Please include the correct answer with your post-test question.
(Required)
[Saturday Presentation] Please include the correct answer with your post-test question.
(Required)
Presentation Details
Our CE Co-sponsor requires either a presentation slideshow, or outline, along with a bibliography listing at least 2 references from the last 5 years from each presenter. If you have a slideshow already completed, please upload your slideshow as a PDF. If you're still in the process of creating your presentation, please upload a 1-2 page thorough outline detailing its content.
[Friday Presentation] You must select one of the drop box items below:
(Required)
Presentation Outline
Presentation Slideshow
[Friday Presentation] Upload either slideshow or outline consistent with above choice.
(Required)
For easy reading of slideshows, please use bold print with a font size of 24 or greater.
Max. file size: 10 MB.
[Saturday Presentation] You must select one of the drop box items below:
(Required)
Presentation Outline
Presentation Slideshow
[Saturday Presentation] Upload either slideshow or outline consistent with above choice.
(Required)
For easy reading of slideshows, please use bold print with a font size of 24 or greater.
Max. file size: 10 MB.
Please upload a 1-2 page bibliography listing the most relevant references for both presentations.
(Required)
At least two references must be from within the last five years.
This is a requirement set forth by our co-sponsors.
Max. file size: 10 MB.