APFM 2021

A New Beginning: Reimagining the Art and Science of Family Mediation

Conference: October 15-16, 2021
Preconference Institutes October 14
online via Zoom


Panelist and Moderator Agreement

2021 Moderator Agreement & Release
Are you a Moderator or a Panelist?

Speaker Info

This will be listed on all conference materials.
This will be listed on all conference materials. Please include all designations.
We need a phone number to which we can text you on the day of the session.
Address
Address
City
State/Province
Zip/Postal
Country
Please include degrees, professional license numbers, expiration dates, and states where they are valid. End with current job description (one sentence).
Maximum upload size: 5MB
PDFs preferred. Word processing documents and text files also allowed. 5MB maximum upload.

Speaker Agreement

Participation *
Technology *
Expenses *
Registration *
Notification *
For questions, please contact Beth Goldfarb at [email protected] or 508-735-0961.
Content *

Release

I AGREE THAT THE ACADEMY OF PROFESSIONAL FAMILY MEDIATORS MAY:
Use of Name and Bio *
Use of Content *
Use of Content for Members *
Understanding *

Questions, please contact:

Beth Goldfarb
[email protected]
508-735-0961

Presentation Content

Course content level:
Provide 3-4 current (within the last 5 years) scholarly sources that pertain to the content of your panel. Please do not include more than one source of which you are the author.

Signature and Agreement Submission

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