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call for papers--APSAC COlloquium--Hollywood, CA--deadline extended to August 15



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<H3 style="MARGIN: 0in 0in 0pt"><U><SPAN style="COLOR: purple"><FONT 
size=6><FONT face="Bookman Old Style">PLAN NOW TO 
ATTEND<o:p></o:p></FONT></FONT></SPAN></U></H3>
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face="Times New Roman">&nbsp;<o:p></o:p></FONT></FONT></P>
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      face="Times New Roman"><IMG height=154 alt=APSAC 
      src="cid:575455117@06082003-0F01"; width=182 
    v:shapes="_x0000_s1026"></FONT></TD></TR></TBODY></TABLE></SPAN><FONT 
size=3><FONT face="Times New Roman">&nbsp;<o:p></o:p></FONT></FONT></P><BR 
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<P class=MsoNormal style="MARGIN: 0in 0in 0pt 2.5in"><SPAN 
style="FONT-SIZE: 14pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman"><SPAN style="mso-spacerun: yes">&nbsp;&nbsp; 
</SPAN><B>American Professional Society on the Abuse of 
Children<o:p></o:p></B></FONT></SPAN></P>
<P class=MsoNormal 
style="MARGIN: 0in 0in 0pt 1.5in; TEXT-INDENT: 0.5in; TEXT-ALIGN: center" 
align=center><B style="mso-bidi-font-weight: normal"><SPAN 
style="FONT-SIZE: 24pt; COLOR: #ff3399; FONT-FAMILY: 'Bookman Old Style'; mso-bidi-font-size: 12.0pt"><SPAN 
style="mso-spacerun: yes">&nbsp;&nbsp; </SPAN></SPAN></B><B 
style="mso-bidi-font-weight: normal"><SPAN 
style="FONT-SIZE: 24pt; COLOR: purple; FONT-FAMILY: 'Bookman Old Style'; mso-bidi-font-size: 12.0pt">12<SUP>h</SUP> 
Annual Colloquium<o:p></o:p></SPAN></B></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; TEXT-ALIGN: center" 
align=center><B style="mso-bidi-font-weight: normal"><SPAN 
style="FONT-SIZE: 14pt; COLOR: fuchsia; FONT-FAMILY: 'Bookman Old Style'; mso-bidi-font-size: 12.0pt"><SPAN 
style="mso-spacerun: yes">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN></SPAN></B><SPAN 
style="FONT-SIZE: 20pt; FONT-FAMILY: 'Bookman Old Style'; mso-bidi-font-weight: bold; mso-bidi-font-size: 12.0pt">August 
4 &#8211; 7, 2004<o:p></o:p></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; TEXT-ALIGN: center" 
align=center><B style="mso-bidi-font-weight: normal"><SPAN 
style="FONT-SIZE: 14pt; COLOR: fuchsia; FONT-FAMILY: 'Bookman Old Style'; mso-bidi-font-size: 12.0pt"><IMG 
height=356 src="cid:575455117@06082003-0F08"; width=655 
v:shapes="_x0000_i1025"><o:p></o:p></SPAN></B></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; TEXT-ALIGN: center" 
align=center><B style="mso-bidi-font-weight: normal"><SPAN 
style="FONT-SIZE: 16pt; COLOR: purple; FONT-FAMILY: 'Comic Sans MS'; mso-bidi-font-size: 12.0pt">Colleagues 
Connecting for Kids&#8230;<o:p></o:p></SPAN></B></P>
<P class=MsoNormal 
style="MARGIN: 0in 0in 0pt 0.5in; TEXT-INDENT: -0.25in; TEXT-ALIGN: center; tab-stops: list .5in; mso-list: l3 level1 lfo9" 
align=center><SPAN 
style="FONT-SIZE: 11pt; FONT-FAMILY: Wingdings; mso-bidi-font-weight: bold; mso-bidi-font-size: 12.0pt">v<SPAN 
style="FONT: 7pt 'Times New Roman'">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN></SPAN><SPAN 
style="FONT-SIZE: 11pt; FONT-FAMILY: 'Comic Sans MS'; mso-bidi-font-weight: bold; mso-bidi-font-size: 12.0pt">Intensive, 
interdisciplinary, skills-based training seminars on all aspects of child 
maltreatment<o:p></o:p></SPAN></P>
<P class=MsoNormal 
style="MARGIN: 0in 0in 0pt 0.5in; TEXT-INDENT: -0.25in; TEXT-ALIGN: center; tab-stops: list .5in; mso-list: l3 level1 lfo9" 
align=center><SPAN 
style="FONT-SIZE: 11pt; FONT-FAMILY: Wingdings; mso-bidi-font-weight: bold; mso-bidi-font-size: 12.0pt">v<SPAN 
style="FONT: 7pt 'Times New Roman'">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN></SPAN><SPAN 
style="FONT-SIZE: 11pt; FONT-FAMILY: 'Comic Sans MS'; mso-bidi-font-weight: bold; mso-bidi-font-size: 12.0pt">Field-generated 
skills training, Research Papers, Poster Presentations, and 
Symposia<o:p></o:p></SPAN></P>
<P class=MsoNormal 
style="MARGIN: 0in 0in 0pt 0.5in; TEXT-INDENT: -0.25in; TEXT-ALIGN: center; tab-stops: list .5in; mso-list: l3 level1 lfo9" 
align=center><SPAN 
style="FONT-SIZE: 11pt; FONT-FAMILY: Wingdings; mso-bidi-font-weight: bold; mso-bidi-font-size: 12.0pt">v<SPAN 
style="FONT: 7pt 'Times New Roman'">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN></SPAN><SPAN 
style="FONT-SIZE: 11pt; FONT-FAMILY: 'Comic Sans MS'; mso-bidi-font-weight: bold; mso-bidi-font-size: 12.0pt">Networking 
opportunities with other professionals and APSAC members in your discipline 
&amp; State<o:p></o:p></SPAN></P>
<P class=MsoNormal 
style="MARGIN: 0in 0in 0pt 0.5in; TEXT-INDENT: -0.25in; TEXT-ALIGN: center; tab-stops: list .5in; mso-list: l3 level1 lfo9" 
align=center><SPAN 
style="FONT-SIZE: 11pt; FONT-FAMILY: Wingdings; mso-bidi-font-weight: bold; mso-bidi-font-size: 12.0pt">v<SPAN 
style="FONT: 7pt 'Times New Roman'">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN></SPAN><SPAN 
style="FONT-SIZE: 11pt; FONT-FAMILY: 'Comic Sans MS'; mso-bidi-font-weight: bold; mso-bidi-font-size: 12.0pt">A 
faculty of internationally recognized experts<o:p></o:p></SPAN></P>
<H6><FONT face="Comic Sans MS"><FONT size=5><SPAN style="COLOR: purple">APSAC&#8217;s 
Annual Colloquium</SPAN><FONT color=#ff3399> </FONT></FONT><SPAN 
style="FONT-WEIGHT: normal; FONT-SIZE: 11pt; COLOR: windowtext; mso-bidi-font-weight: bold; mso-bidi-font-size: 12.0pt">is 
a major source of information and research necessary for interdisciplinary 
professionals in the field of child abuse and 
neglect<o:p></o:p></SPAN></FONT></H6>
<P class=MsoHeading7 style="MARGIN: 0in 0in 0pt"><SPAN 
style="COLOR: purple"><STRONG><FONT size=5><FONT 
face="Comic Sans MS">Learn&#8230;<o:p></o:p></FONT></FONT></STRONG></SPAN></P>
<P class=MsoBodyText3 style="MARGIN: 0in 0in 0pt"><FONT face="Comic Sans MS" 
size=3>In Paper Presentations, Poster Sessions, and Research Symposia; the most 
up-to-date and relevant research and practice information is 
discussed</FONT></P>
<P class=MsoHeading7 style="MARGIN: 0in 0in 0pt"><SPAN 
style="COLOR: purple; mso-bidi-font-weight: bold"><STRONG><FONT size=5><FONT 
face="Comic Sans MS">Network&#8230;<o:p></o:p></FONT></FONT></STRONG></SPAN></P>
<P class=MsoBodyText3 style="MARGIN: 0in 0in 0pt"><FONT face="Comic Sans MS" 
size=3>The Colloquium is where interdisciplinary members and other leaders in 
the field of child maltreatment join forces to advance best practice</FONT></P>
<H2 style="MARGIN: 0in 0in 0pt"><SPAN style="COLOR: windowtext"><FONT 
face="Times New Roman">Training submissions must be postmarked by August 9, 
2003<o:p></o:p></FONT></SPAN></H2>
<H5 style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 18pt; COLOR: purple; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">Research submissions must be postmarked by February 14, 
2004<o:p></o:p></FONT></SPAN></H5>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; TEXT-ALIGN: center" 
align=center><B style="mso-bidi-font-weight: normal"><SPAN 
style="FONT-SIZE: 14pt; COLOR: purple; FONT-FAMILY: 'Bookman Old Style'; mso-bidi-font-size: 12.0pt">&nbsp;<o:p></o:p></SPAN></B></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; TEXT-ALIGN: center" 
align=center><B style="mso-bidi-font-weight: normal"><SPAN 
style="FONT-SIZE: 14pt; COLOR: purple; FONT-FAMILY: 'Comic Sans MS'; mso-bidi-font-size: 12.0pt">APSAC&#8217;s 
12<SUP>th</SUP> Annual National Colloquium<o:p></o:p></SPAN></B></P>
<P class=MsoNormal 
style="MARGIN: 0in 0in 0pt; TEXT-INDENT: 0.5in; TEXT-ALIGN: center" 
align=center><B style="mso-bidi-font-weight: normal"><SPAN 
style="FONT-SIZE: 14pt; COLOR: purple; FONT-FAMILY: 'Comic Sans MS'; mso-bidi-font-size: 12.0pt">August 
4 &#8211; 7, 2004 at the Renaissance Hotel in Hollywood, CA!<o:p></o:p></SPAN></B></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 5pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 10.5pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">Join your colleagues, and bring your family to exciting 
Hollywood for the most energizing professional training of your 
career!<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 5pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; TEXT-ALIGN: center" 
align=center><FONT face="Times New Roman"><B><SPAN 
style="FONT-SIZE: 13pt; COLOR: #333333">A star studded setting, located directly 
off of Hollywood Boulevard and the Hollywood walk of fame, minutes from the 
Kodak Theater, the Pantages theater, Griffith Park, The Famous Hollywood Bowl 
and Universal Studios as well as many other Hollywood attractions. 
</SPAN></B><B><SPAN 
style="FONT-SIZE: 13pt; COLOR: lime"><o:p></o:p></SPAN></B></FONT></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; TEXT-ALIGN: center" 
align=center><B style="mso-bidi-font-weight: normal"><SPAN 
style="FONT-SIZE: 16pt; COLOR: purple; FONT-FAMILY: 'Arial Black'; mso-bidi-font-size: 12.0pt">CALL 
FOR ABSTRACTS:<o:p></o:p></SPAN></B></P>
<H2 style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 14pt; COLOR: windowtext; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">Training submissions must be postmarked by August 9, 
2003<o:p></o:p></FONT></SPAN></H2>
<H5 style="MARGIN: 0in 0in 0pt"><FONT size=5><FONT face="Times New Roman"><SPAN 
style="COLOR: purple">Research submissions must be postmarked by February 14, 
2004</SPAN><SPAN 
style="FONT-SIZE: 16pt; COLOR: purple; mso-bidi-font-size: 12.0pt"><o:p></o:p></SPAN></FONT></FONT></H5>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 5pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></P>
<P class=MsoBodyTextIndent style="MARGIN: 0in 0in 0pt"><FONT 
face="Times New Roman" size=3>APSAC is soliciting abstracts for both training 
and research presentations at the <B 
style="mso-bidi-font-weight: normal">12<SUP>th</SUP> Annual Colloquium</B>, one 
of the field&#8217;s premier forums for child abuse professionals to offer training 
presentations and report new research findings concerning legal, medical, mental 
health, investigative, preventive, and protective services work with abused and 
neglected children, their families, and perpetrators of abuse.<SPAN 
style="mso-spacerun: yes">&nbsp; </SPAN>Presentations are encouraged on all 
aspects of child maltreatment, including cultural diversity.</FONT></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 4pt; COLOR: black; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><FONT size=3><B 
style="mso-bidi-font-weight: normal"><SPAN 
style="COLOR: purple; FONT-FAMILY: 'Berlin Sans FB'">TYPES OF 
PRESENTATIONS:</SPAN></B><B style="mso-bidi-font-weight: normal"><SPAN 
style="COLOR: purple; FONT-FAMILY: 'Britannic Bold'"><o:p></o:p></SPAN></B></FONT></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; TEXT-INDENT: 0.25in"><SPAN 
style="FONT-SIZE: 10.5pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">All presentations should be designed for professionals in 
the field of child maltreatment and should be based upon the latest data in 
scientific research, legal research, and practice knowledge available.<SPAN 
style="mso-spacerun: yes">&nbsp; </SPAN>Presentations can be for either a 
research or practice audience. This may include original empirical studies, 
qualitative studies, legal and policy research or practice based research, 
educational objectives, and the proposed teaching methods to be used.<SPAN 
style="mso-spacerun: yes">&nbsp; </SPAN>Research presentations should include 
appropriate descriptions of the research question, methods, and results.<SPAN 
style="mso-spacerun: yes">&nbsp; </SPAN>For further information, contact Tricia 
Williams by e-mail </FONT><A href="mailto:tricia-williams@ouhsc.edu";><SPAN 
style="FONT-SIZE: 12pt"><FONT 
face="Times New Roman">tricia-williams@ouhsc.edu</FONT></SPAN></A><FONT 
face="Times New Roman"> or by phone at (405) 
271-8202.<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; TEXT-INDENT: 0.25in"><SPAN 
style="FONT-SIZE: 5pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal 
style="MARGIN: 0in 0in 0pt 0.25in; TEXT-INDENT: -0.25in; tab-stops: list .25in; mso-list: l4 level1 lfo3"><SPAN 
style="FONT-SIZE: 10.5pt; FONT-FAMILY: Wingdings; mso-bidi-font-size: 12.0pt">v<SPAN 
style="FONT: 7pt 'Times New Roman'">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN></SPAN><FONT face="Times New Roman"><U><SPAN 
style="FONT-SIZE: 10.5pt; mso-bidi-font-size: 12.0pt">TRAINING SEMINAR 
</SPAN></U><SPAN style="FONT-SIZE: 10.5pt; mso-bidi-font-size: 12.0pt"><SPAN 
style="mso-spacerun: yes">&nbsp;</SPAN>(Practice Only): Skills-building Seminars 
designed to teach professionals innovative and scientifically based practice 
skills (90 minutes). <o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal 
style="MARGIN: 0in 0in 0pt 0.25in; TEXT-INDENT: -0.25in; tab-stops: list .25in; mso-list: l1 level1 lfo2"><SPAN 
style="FONT-SIZE: 10.5pt; FONT-FAMILY: Wingdings; mso-bidi-font-size: 12.0pt">v<SPAN 
style="FONT: 7pt 'Times New Roman'">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN></SPAN><FONT face="Times New Roman"><U><SPAN 
style="FONT-SIZE: 10.5pt; mso-bidi-font-size: 12.0pt">SYMPOSIUM</SPAN></U><SPAN 
style="FONT-SIZE: 10.5pt; mso-bidi-font-size: 12.0pt"> (Research ONLY): Related 
presentations by several speakers on a single topic.<SPAN 
style="mso-spacerun: yes">&nbsp; </SPAN>Symposium presentations often present 
diverse points of view, or present several papers from large, major research 
projects (90 minutes). <o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal 
style="MARGIN: 0in 0in 0pt 0.25in; TEXT-INDENT: -0.25in; tab-stops: list .25in; mso-list: l4 level1 lfo3"><SPAN 
style="FONT-SIZE: 10.5pt; FONT-FAMILY: Wingdings; mso-bidi-font-size: 12.0pt">v<SPAN 
style="FONT: 7pt 'Times New Roman'">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN></SPAN><FONT face="Times New Roman"><U><SPAN 
style="FONT-SIZE: 10.5pt; mso-bidi-font-size: 12.0pt">POSTER 
PRESENTATION</SPAN></U><SPAN 
style="FONT-SIZE: 10.5pt; mso-bidi-font-size: 12.0pt"> (Research or Practice): 
Poster display of research, practice, or program innovations providing the 
opportunity for extended discussion with conference 
participants.<o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal 
style="MARGIN: 0in 0in 0pt 0.25in; TEXT-INDENT: -0.25in; tab-stops: list .25in; mso-list: l4 level1 lfo3"><SPAN 
style="FONT-SIZE: 10.5pt; FONT-FAMILY: Wingdings; mso-bidi-font-size: 12.0pt">v<SPAN 
style="FONT: 7pt 'Times New Roman'">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN></SPAN><FONT face="Times New Roman"><U><SPAN 
style="FONT-SIZE: 10.5pt; mso-bidi-font-size: 12.0pt">PAPER 
PRESENTATION</SPAN></U><SPAN 
style="FONT-SIZE: 10.5pt; mso-bidi-font-size: 12.0pt"> (Research only): Oral 
presentations of previously unpublished results from an original research study 
(20-30 minutes).<o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 5pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">Please send me the following 
information:<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal 
style="MARGIN: 0in -40.5pt 0pt 0in; TEXT-INDENT: 13.5pt"><SPAN 
style="FONT-FAMILY: Wingdings"><FONT size=3>¨<SPAN style="mso-tab-count: 1"> 
</SPAN></FONT></SPAN><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">Information on APSAC&#8217;s 2004 Colloquium<SPAN 
style="mso-tab-count: 2">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN></FONT></SPAN><FONT size=3><SPAN style="FONT-FAMILY: Wingdings">¨ 
</SPAN><FONT face="Times New Roman">Information on Sponsorship<SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><o:p></o:p></SPAN></FONT></FONT></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; TEXT-INDENT: 13.5pt"><SPAN 
style="FONT-FAMILY: Wingdings"><FONT size=3>¨<SPAN style="mso-tab-count: 1"> 
</SPAN></FONT></SPAN><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">Information on Exhibiting at the Colloquium<SPAN 
style="mso-tab-count: 2">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN></FONT></SPAN><SPAN style="FONT-FAMILY: Wingdings"><FONT size=3>¨ 
</FONT></SPAN><SPAN style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">APSAC&#8217;s Professional Publications 
Catalog<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; TEXT-INDENT: 13.5pt"><SPAN 
style="FONT-FAMILY: Wingdings"><FONT size=3>¨<SPAN style="mso-tab-count: 1"> 
</SPAN></FONT></SPAN><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">Information on other training opportunities<SPAN 
style="mso-tab-count: 2">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN></FONT></SPAN><SPAN style="FONT-FAMILY: Wingdings"><FONT size=3>¨ 
</FONT></SPAN><SPAN style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">APSAC&#8217;s Membership 
Information<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 10.5pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">Name/Degree: <U><SPAN 
style="mso-tab-count: 8">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN></U><SPAN style="mso-spacerun: yes">&nbsp;&nbsp;</SPAN>Title:<SPAN 
style="mso-spacerun: yes">&nbsp; </SPAN><SPAN 
style="mso-tab-count: 1"></SPAN><U><SPAN 
style="mso-tab-count: 4">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN><o:p></o:p></U></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 10.5pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 10.5pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">Agency: <U><SPAN 
style="mso-tab-count: 13">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN><o:p></o:p></U></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><U><SPAN 
style="FONT-SIZE: 10.5pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></U></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 10.5pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">Address: <U><SPAN 
style="mso-tab-count: 10">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN><SPAN 
style="mso-tab-count: 3">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN></U><SPAN 
style="mso-tab-count: 1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN><o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 10.5pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 10.5pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">City, State, Zip: <U><SPAN 
style="mso-tab-count: 13">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN></U><SPAN 
style="mso-tab-count: 1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN><o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 10.5pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 10.5pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">Phone:<SPAN style="mso-spacerun: yes">&nbsp; 
</SPAN><U><SPAN 
style="mso-tab-count: 7">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN></U><SPAN style="mso-spacerun: yes">&nbsp;&nbsp;</SPAN>Fax:<SPAN 
style="mso-spacerun: yes">&nbsp; </SPAN><U><SPAN 
style="mso-tab-count: 7">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN></U><SPAN 
style="mso-tab-count: 1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN><o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 10.5pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 10.5pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">E-mail: <U><SPAN 
style="mso-tab-count: 14">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN></U><o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; TEXT-ALIGN: center" 
align=center><SPAN style="COLOR: purple"><FONT size=3><FONT 
face="Times New Roman">Please return to the APSAC office: 
<o:p></o:p></FONT></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; TEXT-ALIGN: center" 
align=center><SPAN style="COLOR: purple"><FONT size=3><FONT 
face="Times New Roman">APSAC, ATTN:<SPAN style="mso-spacerun: yes">&nbsp; 
</SPAN>Tricia Williams, JD<o:p></o:p></FONT></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; TEXT-ALIGN: center" 
align=center><SPAN style="COLOR: purple"><FONT size=3><FONT 
face="Times New Roman">PO Box 26901, CHO 
3B3406<o:p></o:p></FONT></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; TEXT-ALIGN: center" 
align=center><SPAN style="COLOR: purple"><FONT size=3><FONT 
face="Times New Roman">Oklahoma City, OK<SPAN style="mso-spacerun: yes">&nbsp; 
</SPAN>73190<o:p></o:p></FONT></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in -9pt 0pt 0in"><FONT face="Times New Roman" 
size=3>Phone:<SPAN style="mso-spacerun: yes">&nbsp; </SPAN>(405) 271-8202 / 
FAX:<SPAN style="mso-spacerun: yes">&nbsp; </SPAN>(405) 271-2931 / <SPAN 
style="mso-spacerun: yes">&nbsp;</SPAN>Email:<SPAN 
style="mso-spacerun: yes">&nbsp; </SPAN>tricica-williams@ouhsc.edu<SPAN 
style="mso-spacerun: yes">&nbsp; </SPAN>or visit </FONT><A 
href="http://www.apsac.org/";><FONT face="Times New Roman" 
size=3>www.apsac.org</FONT></A></P>
<H1 style="MARGIN: 0in 0in 0pt"><SPAN style="COLOR: purple"><U><FONT 
size=3><FONT face="Times New Roman">MARK ONLY 
ONE<o:p></o:p></FONT></FONT></U></SPAN></H1>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; COLOR: blue; mso-bidi-font-size: 12.0pt"><U><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></U></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">Type of presentation:<SPAN 
style="mso-tab-count: 1">&nbsp;&nbsp;&nbsp;&nbsp; </SPAN>___ Training 
Seminar<SPAN style="mso-spacerun: yes">&nbsp;&nbsp; </SPAN>___Research 
Symposium<SPAN style="mso-spacerun: yes">&nbsp;&nbsp; </SPAN>___Research 
presentation<SPAN style="mso-spacerun: yes">&nbsp;&nbsp; 
</SPAN>___Poster<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">If your abstract has been submitted for another type of 
presentation, are you willing to present as a poster?<SPAN 
style="mso-tab-count: 1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN><o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt 1.5in; TEXT-INDENT: 0.5in"><FONT 
face="Times New Roman"><U><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><SPAN 
style="mso-spacerun: yes">&nbsp;</SPAN><SPAN 
style="mso-tab-count: 1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN></SPAN></U><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><SPAN 
style="mso-spacerun: yes">&nbsp;</SPAN>Yes<SPAN 
style="mso-tab-count: 2">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN><U><SPAN 
style="mso-tab-count: 1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN></U>No<o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt 1.5in; TEXT-INDENT: 0.5in"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">Primary Presentation Format:<SPAN 
style="mso-spacerun: yes">&nbsp; </SPAN>____ Research<SPAN 
style="mso-tab-count: 1">&nbsp;&nbsp;&nbsp; </SPAN>____Practice<SPAN 
style="mso-tab-count: 1">&nbsp;&nbsp;&nbsp; 
</SPAN>____Both<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt 1.5in; TEXT-INDENT: 0.5in"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">What areas will be most interested in your 
presentation?<SPAN style="mso-tab-count: 1">&nbsp; </SPAN>(Please circle 
one)<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman"><SPAN 
style="mso-tab-count: 1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN>Mental Health<SPAN 
style="mso-tab-count: 2">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN>Medicine/Nursing<SPAN 
style="mso-tab-count: 2">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN>Cultural Diversity<SPAN 
style="mso-tab-count: 2">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN>Administration<SPAN 
style="mso-tab-count: 2">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN><SPAN 
style="mso-tab-count: 1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN>Law<SPAN 
style="mso-tab-count: 3">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN>Law Enforcement<SPAN 
style="mso-tab-count: 2">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN>Prevention<SPAN 
style="mso-tab-count: 3">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN>Interdisciplinary<SPAN style="mso-tab-count: 1"> </SPAN><SPAN 
style="mso-tab-count: 1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN>Advocacy/Policy <SPAN 
style="mso-tab-count: 1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN>Child Protection/Child Welfare<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">Title of Presentation: <U><SPAN 
style="mso-tab-count: 11">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN></U><o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">Confine your abstract to the space below, in no smaller 
than 11-point font.<SPAN style="mso-spacerun: yes">&nbsp; </SPAN>To be 
considered, Abstracts must identify at least three educational objectives 
guiding the presentation.<SPAN style="mso-spacerun: yes">&nbsp; </SPAN>If 
cultural issues are relevant, indicate in abstract how they will be addressed. 
<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">Educational Objectives (Please specify at least 
3):<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; TEXT-ALIGN: center" 
align=center><SPAN style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><B 
style="mso-bidi-font-weight: normal"><SPAN 
style="FONT-SIZE: 11pt; COLOR: blue; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></B></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><B 
style="mso-bidi-font-weight: normal"><SPAN 
style="FONT-SIZE: 11pt; COLOR: blue; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></B></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><B 
style="mso-bidi-font-weight: normal"><SPAN 
style="FONT-SIZE: 11pt; COLOR: purple; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></B></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><B 
style="mso-bidi-font-weight: normal"><SPAN 
style="FONT-SIZE: 11pt; COLOR: purple; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></B></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><B 
style="mso-bidi-font-weight: normal"><SPAN 
style="FONT-SIZE: 11pt; COLOR: purple; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></B></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><B 
style="mso-bidi-font-weight: normal"><SPAN 
style="FONT-SIZE: 11pt; COLOR: purple; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></B></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><B 
style="mso-bidi-font-weight: normal"><SPAN 
style="FONT-SIZE: 11pt; COLOR: purple; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></B></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><FONT face="Times New Roman"><B 
style="mso-bidi-font-weight: normal"><SPAN 
style="FONT-SIZE: 11pt; COLOR: purple; mso-bidi-font-size: 12.0pt">ABSTRACT 
INFORMATION FORM</SPAN></B><B style="mso-bidi-font-weight: normal"><SPAN 
style="FONT-SIZE: 11pt; COLOR: blue; mso-bidi-font-size: 12.0pt"> 
</SPAN></B><SPAN style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt">(Side 
Two)<SPAN 
style="mso-tab-count: 2">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN>SUB ID# <U><SPAN 
style="mso-tab-count: 3">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN></U><SPAN style="mso-spacerun: yes">&nbsp;&nbsp;</SPAN>(Office use 
only)<o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">(Please Type or Print)<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">Title of presentation:<SPAN 
style="mso-spacerun: yes">&nbsp; </SPAN><U><SPAN 
style="mso-tab-count: 12">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN><o:p></o:p></U></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">Lead Presenter:<SPAN 
style="mso-tab-count: 2">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN><o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">First name:<SPAN style="mso-spacerun: yes">&nbsp; 
</SPAN><U><SPAN 
style="mso-tab-count: 5">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN></U>Last name:<U><SPAN 
style="mso-tab-count: 5">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN></U>Degree:<U><SPAN 
style="mso-tab-count: 2">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN><o:p></o:p></U></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">Academic/Professional/Clinical Title:<U><SPAN 
style="mso-tab-count: 4">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN></U>Affiliation:<U><SPAN 
style="mso-tab-count: 5">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN></U><SPAN 
style="mso-tab-count: 1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN><o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">Address:<U><SPAN 
style="mso-tab-count: 13">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN></U><o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">City:<SPAN style="mso-spacerun: yes">&nbsp; 
</SPAN><U><SPAN 
style="mso-tab-count: 7">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN></U><SPAN style="mso-spacerun: yes">&nbsp;&nbsp;</SPAN>State:<SPAN 
style="mso-tab-count: 1">&nbsp; </SPAN><U><SPAN 
style="mso-tab-count: 2">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN></U><SPAN style="mso-spacerun: yes">&nbsp; </SPAN>Zip:<SPAN 
style="mso-spacerun: yes">&nbsp; </SPAN><U><SPAN 
style="mso-tab-count: 4">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN></U><SPAN 
style="mso-tab-count: 1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN><o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">Phone:<SPAN style="mso-tab-count: 1">&nbsp; 
</SPAN><U><SPAN 
style="mso-tab-count: 4">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN></U>Fax:<SPAN style="mso-spacerun: yes">&nbsp; </SPAN><U><SPAN 
style="mso-tab-count: 5">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN></U><SPAN style="mso-spacerun: yes">&nbsp;</SPAN>Email:<SPAN 
style="mso-tab-count: 1">&nbsp; </SPAN><U><SPAN 
style="mso-tab-count: 3">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN><o:p></o:p></U></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">APSAC Member:<SPAN style="mso-spacerun: yes">&nbsp; 
</SPAN><U><SPAN 
style="mso-tab-count: 1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN></U>Yes<SPAN style="mso-spacerun: yes">&nbsp; </SPAN><U><SPAN 
style="mso-tab-count: 1">&nbsp;&nbsp;&nbsp; </SPAN><SPAN 
style="mso-spacerun: yes">&nbsp;&nbsp;&nbsp;</SPAN></U>No<SPAN 
style="mso-tab-count: 2">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN><U><o:p></o:p></U></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">Co-Presenter: <U><SPAN 
style="mso-tab-count: 13">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN><o:p></o:p></U></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">First name:<SPAN style="mso-spacerun: yes">&nbsp; 
</SPAN><U><SPAN 
style="mso-tab-count: 5">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN></U>Last name:<U><SPAN 
style="mso-tab-count: 5">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN></U>Degree:<U><SPAN 
style="mso-tab-count: 2">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN><o:p></o:p></U></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">Academic/Professional/Clinical Title:<U><SPAN 
style="mso-tab-count: 4">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN></U>Affiliation:<U><SPAN 
style="mso-tab-count: 5">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN></U><SPAN 
style="mso-tab-count: 1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN><o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">Address:<U><SPAN 
style="mso-tab-count: 13">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN></U><o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">City:<SPAN style="mso-spacerun: yes">&nbsp; 
</SPAN><U><SPAN 
style="mso-tab-count: 7">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN></U><SPAN style="mso-spacerun: yes">&nbsp;&nbsp;</SPAN>State:<SPAN 
style="mso-tab-count: 1">&nbsp; </SPAN><U><SPAN 
style="mso-tab-count: 2">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN></U><SPAN style="mso-spacerun: yes">&nbsp; </SPAN>Zip:<SPAN 
style="mso-spacerun: yes">&nbsp; </SPAN><U><SPAN 
style="mso-tab-count: 4">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN></U><SPAN 
style="mso-tab-count: 1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN><o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">Phone:<SPAN style="mso-tab-count: 1">&nbsp; 
</SPAN><U><SPAN 
style="mso-tab-count: 4">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN></U>Fax:<SPAN style="mso-spacerun: yes">&nbsp; </SPAN><U><SPAN 
style="mso-tab-count: 5">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN></U><SPAN style="mso-spacerun: yes">&nbsp;</SPAN>Email:<SPAN 
style="mso-tab-count: 1">&nbsp; </SPAN><U><SPAN 
style="mso-tab-count: 3">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN><o:p></o:p></U></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">APSAC Member:<SPAN style="mso-spacerun: yes">&nbsp; 
</SPAN><U><SPAN 
style="mso-tab-count: 1">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN></U>Yes<SPAN style="mso-spacerun: yes">&nbsp; </SPAN><U><SPAN 
style="mso-tab-count: 1">&nbsp;&nbsp;&nbsp; </SPAN><SPAN 
style="mso-spacerun: yes">&nbsp;&nbsp;&nbsp;</SPAN></U>No<SPAN 
style="mso-tab-count: 2">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN><o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><FONT face="Times New Roman"><B 
style="mso-bidi-font-weight: normal"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt">*PLEASE NOTE: 
</SPAN></B><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt">Correspondence regarding 
this abstract submission will be directed to the lead presenter.<SPAN 
style="mso-spacerun: yes">&nbsp; </SPAN>Lead and co-presenters whose abstracts 
are accepted will receive a discount on the full conference registration 
fee.<SPAN style="mso-spacerun: yes">&nbsp; </SPAN>All presenters are expected to 
attend the Colloquium.<SPAN style="mso-spacerun: yes">&nbsp; </SPAN>APSAC does 
not pay any conference or travel expenses for presenters.<SPAN 
style="mso-spacerun: yes">&nbsp; </SPAN>Presenters are responsible for their own 
travel arrangements.<o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 8pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><B 
style="mso-bidi-font-weight: normal"><SPAN style="COLOR: purple"><FONT 
size=3><FONT face="Times New Roman">Submission 
Requirements:<o:p></o:p></FONT></FONT></SPAN></B></P>
<P class=MsoNormal 
style="MARGIN: 0in 0in 0pt 0.75in; TEXT-INDENT: -0.5in; tab-stops: .75in; mso-list: l6 level1 lfo5"><SPAN 
style="FONT-SIZE: 16pt; FONT-FAMILY: Wingdings; mso-bidi-font-size: 12.0pt">v<SPAN 
style="FONT: 7pt 'Times New Roman'">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN></SPAN><FONT face="Times New Roman"><B 
style="mso-bidi-font-weight: normal"><U><SPAN 
style="FONT-SIZE: 14pt; mso-bidi-font-size: 12.0pt">Submissions by e-mail are 
preferred</SPAN></U></B><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt">.<SPAN 
style="mso-spacerun: yes">&nbsp; </SPAN>E-mailed submissions should include all 
information on the submission form, plus a current vitae and brief biographical 
sketch for each presenter (up to 3 presenters).<SPAN 
style="mso-spacerun: yes">&nbsp; </SPAN>E-mail file attachments should be in 
MS-Word, Rich Text Format or ASCII format.<SPAN style="mso-spacerun: yes">&nbsp; 
</SPAN>Submission forms can be found on the APSAC web site 
(<U>www.apsac.org)</U>.<SPAN style="mso-spacerun: yes">&nbsp; </SPAN></SPAN><B 
style="mso-bidi-font-weight: normal"><SPAN 
style="FONT-SIZE: 16pt; FONT-FAMILY: 'Comic Sans MS'; mso-bidi-font-size: 12.0pt"><o:p></o:p></SPAN></B></FONT></P>
<P class=MsoNormal 
style="MARGIN: 0in 0in 0pt 0.75in; TEXT-INDENT: -0.5in; tab-stops: .75in; mso-list: l6 level1 lfo5"><SPAN 
style="FONT-SIZE: 16pt; FONT-FAMILY: Wingdings; mso-bidi-font-size: 12.0pt">v<SPAN 
style="FONT: 7pt 'Times New Roman'">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
</SPAN></SPAN><FONT face="Times New Roman"><SPAN 
style="FONT-SIZE: 11pt; mso-bidi-font-size: 12.0pt">Mail submissions should 
include one hard copy of the submission form (both sides) and bio and curriculum 
vitae for each presenter (up to 3).<SPAN style="mso-spacerun: yes">&nbsp; 
</SPAN>Please provide complete and clear contact information for lead and 
co-presenters.<SPAN style="mso-spacerun: yes">&nbsp; </SPAN>The abstract should 
be submitted on plain white paper with 1&#8221; margins, in no less than 11 pt. 
font.<SPAN style="mso-spacerun: yes">&nbsp; </SPAN>A PC diskette or CD-ROM copy 
of the abstract, objectives and biographical sketches, is also required. 
</SPAN><B style="mso-bidi-font-weight: normal"><SPAN 
style="FONT-SIZE: 16pt; FONT-FAMILY: 'Comic Sans MS'; mso-bidi-font-size: 12.0pt"><o:p></o:p></SPAN></B></FONT></P>
<P class=MsoNormal 
style="MARGIN: 0in 0in 0pt 0.25in; TEXT-ALIGN: center; tab-stops: .75in" 
align=center><B style="mso-bidi-font-weight: normal"><SPAN 
style="FONT-SIZE: 11pt; FONT-FAMILY: 'Comic Sans MS'">&nbsp;<o:p></o:p></SPAN></B></P>
<P class=MsoBodyText style="MARGIN: 0in 0in 0pt"><STRONG><FONT 
face="Comic Sans MS"><SPAN style="FONT-SIZE: 11pt"><FONT color=#9900cc>Training 
Submissions must be postmarked by August 9, 2003</FONT></SPAN><SPAN 
style="FONT-SIZE: 11pt; COLOR: #ff3399"> </SPAN><FONT color=#9900cc><SPAN 
style="FONT-SIZE: 11pt">to be considered.</SPAN><SPAN 
style="FONT-SIZE: 11pt; COLOR: purple"><o:p></o:p></SPAN></FONT></FONT></STRONG></P>
<P class=MsoBodyText style="MARGIN: 0in 0in 0pt"><STRONG><FONT 
face="Comic Sans MS"><SPAN style="FONT-SIZE: 11pt; COLOR: purple">Research 
Submissions must be postmarked by </SPAN><SPAN 
style="FONT-SIZE: 11pt; COLOR: windowtext">February 14, 2004</SPAN><SPAN 
style="FONT-SIZE: 11pt"><FONT color=#9900cc> </FONT></SPAN><SPAN 
style="FONT-SIZE: 11pt; COLOR: purple">to be 
considered.<o:p></o:p></SPAN></FONT></STRONG></P>
<P class=MsoBodyText style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 8pt; mso-bidi-font-size: 16.0pt"><STRONG><FONT 
color=#9900cc><FONT 
face="Comic Sans MS">&nbsp;<o:p></o:p></FONT></FONT></STRONG></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="Z-INDEX: 1; MARGIN: 2px auto auto 504px; WIDTH: 219px; POSITION: absolute; HEIGHT: 106px; mso-ignore: vglayout">
<TABLE cellSpacing=0 cellPadding=0>
  <TBODY>
  <TR>
    <TD 
    style="BORDER-RIGHT: black 0.75pt solid; BORDER-TOP: black 0.75pt solid; BACKGROUND: white; VERTICAL-ALIGN: top; BORDER-LEFT: black 0.75pt solid; BORDER-BOTTOM: black 0.75pt solid" 
    vAlign=top align=left width=219 bgColor=white height=106><SPAN 
      style="Z-INDEX: 2; POSITION: absolute">
      <TABLE cellSpacing=0 cellPadding=0 width="100%">
        <TBODY>
        <TR>
          <TD 
          style="BORDER-RIGHT: #ece9d8; BORDER-TOP: #ece9d8; BORDER-LEFT: #ece9d8; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent">
            <DIV class=shape 
            style="PADDING-RIGHT: 7.2pt; PADDING-LEFT: 7.2pt; PADDING-BOTTOM: 3.6pt; PADDING-TOP: 3.6pt" 
            v:shape="_x0000_s1027">
            <P class=MsoNormal style="MARGIN: 0in 0in 0pt; TEXT-ALIGN: center" 
            align=center><STRONG><FONT face="Times New Roman">FIRST CLASS 
            <o:p></o:p></FONT></STRONG></P>
            <P class=MsoNormal style="MARGIN: 0in 0in 0pt; TEXT-ALIGN: center" 
            align=center><B style="mso-bidi-font-weight: normal"><FONT 
            face="Times New Roman">POSTAGE<o:p></o:p></FONT></B></P>
            <P class=MsoNormal style="MARGIN: 0in 0in 0pt; TEXT-ALIGN: center" 
            align=center><B><FONT 
            face="Times New Roman">PAID<o:p></o:p></FONT></B></P>
            <P class=MsoNormal style="MARGIN: 0in 0in 0pt; TEXT-ALIGN: center" 
            align=center><FONT face="Times New Roman">Oklahoma City, 
            OK</FONT></P>
            <P class=MsoNormal style="MARGIN: 0in 0in 0pt; TEXT-ALIGN: center" 
            align=center><FONT face="Times New Roman">Permit 
            #220</FONT></P></DIV></TD></TR></TBODY></TABLE></SPAN><FONT 
      face="Times New Roman">&nbsp;</FONT></TD></TR></TBODY></TABLE></SPAN><B><SPAN 
style="FONT-SIZE: 10pt; FONT-FAMILY: 'Albertus (W1)'; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">American Professional Society on the Abuse of 
Children<o:p></o:p></FONT></SPAN></B></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><B><SPAN 
style="FONT-SIZE: 10pt; FONT-FAMILY: 'Albertus (W1)'; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">PO Box 26901, CHO 3B3406<o:p></o:p></FONT></SPAN></B></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><B><SPAN 
style="FONT-SIZE: 10pt; FONT-FAMILY: 'Albertus (W1)'; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">Oklahoma City, OK 73190<o:p></o:p></FONT></SPAN></B></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><B><SPAN 
style="FONT-SIZE: 10pt; FONT-FAMILY: 'Albertus (W1)'; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">405-271-8202 </FONT></SPAN></B><B><SPAN 
style="FONT-SIZE: 10pt; FONT-FAMILY: Wingdings; mso-bidi-font-size: 12.0pt; mso-ascii-font-family: 'Albertus (W1)'; mso-hansi-font-family: 'Albertus (W1)'; mso-char-type: symbol; mso-symbol-font-family: Wingdings"><SPAN 
style="mso-char-type: symbol; mso-symbol-font-family: Wingdings">s</SPAN></SPAN></B><B><SPAN 
style="FONT-SIZE: 10pt; FONT-FAMILY: 'Albertus (W1)'; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">Fax 405-271-2931<o:p></o:p></FONT></SPAN></B></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><B><SPAN 
style="FONT-SIZE: 10pt; FONT-FAMILY: 'Albertus (W1)'; mso-bidi-font-size: 12.0pt"><A 
href="mailto:tricia-williams@ouhsc.edu";><FONT 
face="Times New Roman">tricia-williams@ouhsc.edu</FONT></A><SPAN 
style="mso-spacerun: yes"><FONT face="Times New Roman">&nbsp;&nbsp; 
</FONT></SPAN><A href="http://www.apsac.org/";><FONT 
face="Times New Roman">www.apsac.org</FONT></A><o:p></o:p></SPAN></B></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN 
style="FONT-SIZE: 9pt; mso-bidi-font-size: 12.0pt"><FONT 
face="Times New Roman">&nbsp;<o:p></o:p></FONT></SPAN></P></FONT></DIV></BODY></HTML>

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