RFP FORM | lcautism.org

15TH ANNUAL SOUTHWEST WASHINGTON AUTISM CONFERENCE

We are seeking Breakout Session Speakers who:

Live, work, and thrive in either the Southwest Washington area and have a specific and qualified interest, experience or expertise in areas relevant to neurodiversity, autism, or developmental disabilities. Although preferred, this is not a requirement as some speaker contributions align wholly with our intent and overall mission, allowing for qualified exceptions.

We seek those who are passionate about sharing their knowledge and experiences involving the interconnected pathways that live in the spaces in between systems and community.

Every day, autistic and neurodivergent individuals, their families, and the professionals who support them navigate the spaces between healthcare, education, employment, community resources, and everyday life. While each system plays an important role, meaningful support often happens in the connections between them.

That is where collaboration begins.

That is where innovation happens.

That is The Space Between.

If this sounds like you, please submit your proposal today!

First name

Last name

Street Adress

City

State

Zip Code

Phone

Speaker's Title or Position (If Applicable) - This will be listed with your bio

Preferred method of communication:

Phone

Text

Other

Do you need any accommodations? If so, please list below

Proposal Guidelines

Session Title: A concise and engaging title for your session.

Session Description: A brief overview of the session content

Speaker Bio: A short biography including your background, expertise, and connection to the community.

Learning Objectives: Clearly defined objectives that attendees will gain from your session.

Format: Specify the format of your session (e.g., lecture, workshop, interactive discussion, other).

Duration: Indicate the preferred length of your session (typically 45-60 minutes).

What type of equipment might you need for your presentation? (i.e., laptop to borrow (I will bring USB Drive), have a laptop but will need HDMI or other cords, projector/screen, assistive equipment, other)? Please explain.

Do you require any technological assistance to operate your equipment? If yes, please explain. If no, write N/A.

Will you have handouts or materials for your presentation? If yes, would you like LCAC to print them in advance or will you be providing your own?

Do you agree to attend a thirty-minute pre-conference meeting (virtual or in-person) to review your presentation, equipment and technology required, and day-of event details?

Yes

Other

As a nonprofit organization, we are hoping for speakers who value contribution to community over the dollar. That being said, honorariums are necessary sometimes and we know that.

We are committed to discussing fair arrangements to honor your time and expertise. In return, we are pleased to offer:

1) Recognition on our conference program and website.

2) Complimentary conference registration (Includes lunch).

3) Opportunities to network with other professionals and community members.

4) Promotion of your work and services through our social media channels.

Please enter a desired honorarium amount:

I am able to offer my session free of charge in support of LCAC's mission.

Please upload the following images, links, logos (if available).

Website URL: (Please provide the URL you would like linked to your logo or name.)

Social Media Tags/Handles: (Please provide your official social media tags/handles for recognition.)

Professional Headshot

If presenting on behalf of an organization, is that organization interested in hosting a Resource / Vendor table during the registration and lunch hour of the Conference?

I am interested in a resource / vendor table.

I am not interested in a resource / vendor table.

I may be interested.

Other

Permission to Use Branding Materials: I hereby grant permission to the Lewis County Autism Coalition to use uploaded media for the SWWA Autism Conference. Sign or upload Signature Image of Authorized Individual.

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.

These permissions include:

Event Materials (flyers, brochures, banners, etc.)
Event Website
Social Media Posts
Press Releases
Other promotional materials related to the event

Thank you in advance for submitting your proposal. Following review of your proposal, LCAC will contact you. we thank you and we look forward to speaking with you soon!

Join us in celebrating neurodiversity and empowering autistic voices in our community!

• Facebook: https://www.facebook.com/lewiscountyautismcoalition/

• Instagram: @lewiscountyautismcoalition

Please type the name of the authorized person completing and signing this form.