Name: _____________________________________

Phone: ________________(day)_________________(evening)

E-mail addr:_____________________________________

Address: _____________________________________

_____________________________________

City/St/Zip: _____________________________________

Session Title: _______________________________________________________

Type of Session (check all that apply):
____ Experiential Workshop or Playshop. ____Presentation. ____Gathering.
____ Discussion. ____Slide/Video. ____Panel discussion. ____Exhibit.
____ Other type:_______________________ .

Please designate if session is open to: ____Men & Women ____Men only.

Are you willing to repeat your session later in the symposium to give another
opportunity to participants to attend it? ____Yes. ____No.

Purpose of Session (Why is your topic needed at our Symposium?):
How does your topic relate to our Symposium theme and mission?
[Mission: “To educate and inspire men to improve their own health (self-care).”]









Your specifications:
Group Size, Room Requirements, Visual Aids needed, etc.









Session Description:
Please describe your session as you would like it to appear in the conference program
(max: 60 words). Please also attach a longer abstract of your session (up to 250 words).









Biographical Information:
We want to include a short description of you in the Symposium Program;
please tell us something about yourself.








Any other comments you wish to share with us?

Please submit by: Wednesday, June 27, 2001.

Mail to: 2001 MHWS or E-mail to: tcmc@tcfreenet.org
Twin Cities Men’s Center
3249 Hennepin Ave S. #55
Minneapolis, MN 55408



- The 2001 MHWS Planning Group:
Peter Mitchell, Chair, Program Task Group
Stephen Sewell, Dean Jurek, J.C. Hancock, Ranslow Zuber
Andy Mickel, Symposium Co-Chair
John Kuyper, Chair, Facilities Task Group
Gregg DuShon, Tom Perrault
Tom Perrault, Chair: Exhibits Task Group