Webinar Proposal and Planning Form

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Thank you for your interest in presenting an ASCA-sponsored webinar!

The ASCA Central Office staff will work with you to plan, promote, and actualize your program. Be advised that we will do our best to accommodate all requests made, however, flexibility regarding dates and times may be necessary depending on other events and our program schedule.

Unless otherwise directed by the ASCA Executive Director, the following standard webinar rates (see below) will be charged to member and non-member participants:

ASCA Members: $29
Non-Members: $49
ASCA Student Members: $15

Questions about this form or the process of offering a webinar? Contact the Assistant Executive Director, Amanda Mesirow, at aed@theasca.org or 979-589-4604 X105.

Please submit the webinar request form at least 20 business days prior to the preferred webinar date. We ask for this much lead time so we are able to successfully market your webinar as well as handle requested accommodations.

*All ASCA sponsored webinars are recorded for registrants and future ASCA use. Please request the Webinar Agreement from the Assistant Executive Director, Amanda Mesirow, at aed@theasca.org, for further information.

Email *

Webinar Contact Person's Name *

Webinar Contact Person's Email *

Webinar Contact Person's Phone *

Webinar Title (Working Title if undecided) *

Please provide a brief (50 words max.) abstract of the webinar to be used for promotion.
*

I would like this webinar to be considered for Student Affairs Educator Certification Continuing Education credits. Student Affairs Educator Certification Continuing Education Credits. (The Assistant Executive Director will contact you with details.) Please note that per SAEC requirements, we must submit for approval in advance. Your webinar date may therefore be altered. *

Yes

Maybe

Preferred Webinar Date(s) *

YYYY

Alternate Webinar Date(s) *

YYYY

Webinar Start Time (Eastern Time) *

Time

Webinar End Time (Eastern Time) *

Time

Webinars are scheduled for an hour. Will you be requesting more time? *

Yes

Maybe

1st Presenter's Name and Pronouns (Please also include prefixes such as Dr., Dra., Mx., Ms., Mr., etc.)
Example: Dr. Naomi Smith (she/her/hers) *

1st Presenter's Institution or Organization *

1st Presenter's Title *

1st Presenter's Bio (for marketing and webinar introduction; 50-150 words max.) *

2nd Presenter's Name and Pronouns (Please also include prefixes such as Dr., Dra., Mx., Ms., Mr., etc.)
Example: Dr. Naomi Smith (she/her/hers)

2nd Presenter's Institution or Organization

2nd Presenter's Title

2nd Presenter's Email *

2nd Presenter's Bio (for marketing and webinar introduction; 50-150 words max.)

Additional Presenter(s) Name, Pronouns, Institution, Position, and Email (We will contact for bio)

Name of sponsoring Committee, Community of Practice, region, or state (if applicable)

Name of other sponsoring organization (if applicable)

Select at least two (2) intended Student Conduct Learner Levels *

Graduate Student Learner

Entry-Level Learner (1-3 years)

Mid-Level Learner (4-7 years)

Senior Learner (8+ years)

Senior Student Affairs Learner

Required

Program fits one (1) indicated ASCA Learning Priority:
*

Core Competencies of Student Conduct: foundations of knowledge, skill, and attitudes utilized in effective practice

Administration & Research: strategies and techniques in management of human, financial, facilities, technology, and other resources as well as use, design, and critique of research

Student Development & Learning: concepts and principles of how students learn and develop

Professional Development: ongoing growth of members' emotional, physical, social, environmental, relational, spiritual, aspirational, and intellectual wellness

Current Issues: timely subjects, questions, and concerns that impact and inform student conduct

Please list at least two (2) Learning Outcomes associated with this webinar that match the ASCA Learning Priority you selected above. *

Any additional information that would be helpful.

Please review the following statements and click each to indicate agreement with ASCA webinar policies. *

ASCA staff reserves the right to determine final webinar pricing.

Webinars are recorded for the future use of attendees and ASCA, however presenters retain all intellectual property rights to their work.

Each presenter will be permitted to register up to two employees from their institution free of charge. Please contact the ASCA Office at asca@theasca.org to arrange these registrations.

Webinar presenters may be eligible for a share of income generated if the total gross revenue for the event is sufficient to merit a revenue share. A member of the ASCA staff will be in contact after the conclusion of the webinar if this clause applies to your presentation.

You will be required to complete a webinar agreement form that will outline further ASCA guidelines and policies.

Required

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