Title of Proposed Workshop Session:


Descriptive Paragraph: In 50-70 words, please describe the workshop content. Write a problem statement, explain how the content of the workshop addresses this problem, and identify who will benefit from attending this session.

Title: Esq. Mr. Mrs. Ms. Degree: Have you passed ACA's Certification Examination (which one)? CCE (Certified Corrections Executive) CCM (Certified Corrections Manager) CCS (Certified Corrections Supervisor) CCO (Certified Corrections Officer) First Name: Last Name: Job Title: Agency/Organization: Division/Department/Office: Facility/Program:		Address City State AL AK AZ AR CA CO CT DC DE FL GA HI ID IL IN IA KS KY LA MA MD ME MI MN MO MS MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip Code Work Phone: Home Phone: Fax: Email:
References: (Please list two references: Name, Job Title and Phone Number.)
Name: Job Title: Phone Number:	Name: Job Title: Phone Number:
ACA Program Committee Speaker/Participant Registration Policy 2002 If a speaker, who is a nonmember, is not employed in the field of corrections and is attending the Conference only for his/her presentation and will not be visiting the Exhibit Hall, he/she can apply for a waiver of the registration fee. A badge allowing the speaker access to his/her session will be prepared for him/her and will be available at the conference registration area, if the fee is waived. If a speaker, who is a nonmember, works directly within the field of corrections or if he/she is out of the field, however, earns a living via the field (i.e., vendor, professor, consultant), he/she shall pay the registration fee regardless of the number of sessions that he/she will be presenting at or attending. This policy also applies to retired correctional professionals and foreign participants working in the field. (One day registration is available at less cost than full registration.) Speakers who represent private vendors or companies shall not use the speaker role as a forum to market specific products or services, but rather must present a generic presentation on the topic. Furthermore, products and services for which the speaker represents shall not be named or referred to by name in any presentation. Attendees with questions about such products or services shall be informed to see an individual at the conclusion of the presentation and/or program. Attendees may also be directed to visit various booths in the Exhibit Hall. All ACA members who are speakers will pay a registration fee. (As approved by ACA?s Board of Governors on August 4, 2002.) Please mail, fax or e-mail: Kelli McAfee, Professional Development Specialist, American Correctional Association, 206 North Washington Street. Suite 200, Alexandria, VA 22314, 1-800-222-5646 ext. 0173, Fax: 703-224-0166, e-mail: kellim@aca.org Please enter the value you see into the textbox below: RX106CM2LD29QYQL7H8V