Address:
City: State: Zip:
Telephone: (day); (night)
Fax Number: E-mail:
Workshop Title:
Audience for which workshop is designed: Camp Staff Member Camp Professional (1-5 Years) Camp Professional (5-10 Years) Camp Professional (beyond 10 years) Youth Educator (i.e. 4-H Agent, Teacher) All NCI Participants
Description (75 word limit-as it should appear in program):
Objective (specific statement for presentation):
Major Subject Area (check one): Camp Management Camp Programming/Activities Staff/Counselors Publicity and Marketing Risk Management Development/Resources Camp Research/Evaluation Camper Development and Behavior Other (Please list)
Preferred group size: minimum maximum
Desired length of workshop: 1 1/2 hours 3 hours Other
Equipment Requestes: Please indicate any audiovisual or other equipment needed for your session.
Please include a brief biographical sketch of workshop presrenter(s) for introduction (25 words or less):
