Lilly West 2010 Conference

22nd Annual Lilly Conference on College and University Teaching - West

March 12-13, 2010

Kellogg West Ranch
California Polytechnic State University, Pomona

Proposal Submission Form

NOTE: The official due date has passed. We are still accepting proposals – and encourage you to send yours in – but we will not be able to review them until after reviewing the proposals received by the due date. You will be contacted when your review is completed. Thanks for your interest.

Presentations for the conference are selected through a peer review process. The 2010 Lilly-West Conference invites written proposals for 90-minute workshops, 45-minute concurrent sessions, and 60-minute Exemplary Practice Poster sessions.

Proposals may be designed to be of value to both new and experienced and participants, or to one of those groups. Because of the time and space limitations of the conference, it is probable that each individual will be limited to one place on the conference program. However, prospective presenters are welcome to submit more than one proposal; the conference planning committee may recommend one of those proposals over another as the program needs suggest.

Because Lilly Conferences are learning communities, where each member of the community – both presenter and participant – is a valued contributor, proposal submission represents a commitment to present the session if the proposal is accepted, and to participate in the entire conference.

Part 1: Presenter Info

Primary presenter:

Contact info

First Name:

Middle Name/Initial:

Last Name:

Department:

Institution:

Title:

Position:

Address:

City:

State/Prov.:

ZIP/Postal Code:

Country:

Work phone #: (include country code if outside US)

Fax #: (include country code if outside US)

Cell phone #: (include country code if outside US)

Email:

If there are additional presenters for your session, please fill out the information below. Otherwise, you may skip to part two of the form and fill out the session information.

Additional presenter #1

Contact info

First Name:

Middle Name/Initial:

Last Name:

Department:

Institution:

Title:

Position:

Address:

City:

State/Prov.:

ZIP/Postal Code:

Country:

Work phone #: (include country code if outside US)

Fax #: (include country code if outside US)

Cell phone #: (include country code if outside US)

Email:

If there are additional presenters for your session, please fill out the information below. Otherwise, you may skip to part two of the form and fill out the session information.

Additional presenter #2

Contact info

First Name:

Middle Name/Initial:

Last Name:

Department:

Institution:

Title:

Position:

Address:

City:

State/Prov.:

ZIP/Postal Code:

Country:

Work phone #: (include country code if outside US)

Fax #: (include country code if outside US)

Cell phone #: (include country code if outside US)

Email:

If there are additional presenters for your session, please fill out the information below. Otherwise, you may skip to part two of the form and fill out the session information.

Additional presenter #3

Contact info

First Name:

Middle Name/Initial:

Last Name:

Department:

Institution:

Title:

Position:

Address:

City:

State/Prov.:

ZIP/Postal Code:

Country:

Work phone #: (include country code if outside US)

Fax #: (include country code if outside US)

Cell phone #: (include country code if outside US)

Email:

If there are additional presenters for your session, please fill out the information below. Otherwise, you may skip to part two of the form and fill out the session information.

Additional presenter #4

Contact info

First Name:

Middle Name/Initial:

Last Name:

Department:

Institution:

Title:

Position:

Address:

City:

State/Prov.:

ZIP/Postal Code:

Country:

Work phone #: (include country code if outside US)

Fax #: (include country code if outside US)

Cell phone #: (include country code if outside US)

Email:

If there are additional presenters for your session, please fill out the information below. Otherwise, you may skip to part two of the form and fill out the session information.

Additional presenter #5

Contact info

First Name:

Middle Name/Initial:

Last Name:

Department:

Institution:

Title:

Position:

Address:

City:

State/Prov.:

ZIP/Postal Code:

Country:

Work phone #: (include country code if outside US)

Fax #: (include country code if outside US)

Cell phone #: (include country code if outside US)

Email:

Part 2: Session Info

Amount of Time/Type of Session Requested

Please select your first choice:

Exemplary Practice Poster Session
90-Minute Workshop
45-Minute Individual or Team Presentation: Present and explain your Scholarship of Teaching and Learning project, using active discussion and learning strategies to engage your audience.

A/V equipment

The following will be available in in all presentation rooms:

Slide Projector
Video Cassette Player and Monitor
Overhead Projector and Screen
Flip Chart or Blackboard
Projector for Computer (you must bring your own laptop)
Wireless Internet

Presentation Details

Presentation Title:

Presentation Objectives:

Presentation Activities:

Relevant Bibliographic Citations on Topics:

Presentation Description (75 words maximum) of your session:
This will be included in the conference program and is an excellent opportunity to interest potential participants in your session. Be sure to include what will go on in the session, not summarize your research.

Other comments/requests:

I understand that Lilly Conferences are learning communities, where each member of the community – both presenter and participant – is a valued contributor and that my proposal submission represents a commitment, on my part, to present the session if the proposal is accepted.
(List all presenters' full names)

Before you submit this form, please review your information, and then print a copy for your records. Don't forget that presenters must also register for the conference. You will be given the opportunity to do so after submitting this form.

International Alliance of
Teacher Scholars

Twenty-Two Years of Presenting the Scholarship of Teaching and Learning

Lilly West 2010 Conference

22nd Annual Lilly Conference on College and University Teaching - West

March 12-13, 2010

Kellogg West Ranch
California Polytechnic State University, Pomona

Proposal Submission Form

NOTE: The official due date has passed. We are still accepting proposals – and encourage you to send yours in – but we will not be able to review them until after reviewing the proposals received by the due date. You will be contacted when your review is completed. Thanks for your interest.

Part 1: Presenter Info

Primary presenter:

Additional presenter #1

Additional presenter #2

Additional presenter #3

Additional presenter #4

Additional presenter #5

Part 2: Session Info

Amount of Time/Type of Session Requested

A/V equipment

Presentation Details

International Alliance of Teacher Scholars

Twenty-Two Years of Presenting the Scholarship of Teaching and Learning

Lilly West 2010 Conference

22nd Annual Lilly Conference on College and University Teaching - West

March 12-13, 2010

Kellogg West Ranch California Polytechnic State University, Pomona

Proposal Submission Form

NOTE: The official due date has passed. We are still accepting proposals – and encourage you to send yours in – but we will not be able to review them until after reviewing the proposals received by the due date. You will be contacted when your review is completed. Thanks for your interest.

Part 1: Presenter Info

Primary presenter:

Additional presenter #1

Additional presenter #2

Additional presenter #3

Additional presenter #4

Additional presenter #5

Part 2: Session Info

Amount of Time/Type of Session Requested

A/V equipment

Presentation Details

International Alliance of
Teacher Scholars

Kellogg West Ranch
California Polytechnic State University, Pomona