|Presenter Name: First: Last:
Arrival Date:Depart Date:
What you would like to appear in the program guide – please be brief.
Certifications or Experience in Subject (optional):
Please list any certifications, courses attended, previous workshops presented, as appropriate.
A workshop can be offered once or multiple times. Requested number of sessions:
Preferred Date and Start Time: (rank two preferences)
Length of workshop or activity:
We will make every effort to schedule you into the time you request, but sometimes we have conflicts. If we cannot
accommodate your request we will attempt to let you know ahead of time. Most workshops should be 1 hour long.
Workshop or Activity Type: One can expect this workshop or activity to be primarily
Instructional – a workshop or class where attendees will learn about a subject or how to do something.
Recreational – coordinated exercise, hike, aerobics, sport, game and other “play” activities.
Entertainment – event or show.
Additional Information: (for the Workshop Coordinator)
Note: you must be registered for the Northern California Mid-Summer Gathering before you submit a workshop or activity proposal.