DIRECTIONS: Please complete the form below, providing all of the information requested. Then send it by e-mail to stapresent@pegasuscom.com.

Title of Presentation (not more than 10 words, subject to editing)

100-Word Summary of Presentation (subject to editing)

Presenter Information
Contact Presenter’s Name (primary contact for this presentation):
Company:
Address:
City:
State:
Zip or Postal Code:
Country:
Phone:
Fax:
E-mail:

Have you presented at a Systems Thinking in Action/Pegasus Conference before? If yes, what year(s)?

If not, have you attended a Systems Thinking in Action/Pegasus Conference before? If yes, what year(s)?

Are you a subscriber to The Systems Thinker newsletter? If so, for how long?

References (people who have seen you present and can comment on content and your speaking ability)
      Reference #1 (name, company/organization, and phone number):

      Reference #2 (name, company/organization, and phone number):

Additional Presenter (if applicable): Please include all items listed above under “Presenter Information.”

How does this topic relate to the conference theme?

Why should this proposal be presented at this conference as opposed to any other conference?

Have you presented, or do you plan to present, this topic at any other conferences? If yes, please list conference(s) and date(s).

Is this session a Case Study or Skill-Building Workshop?

• The key to a successful case study is that the organizational issue presented is recognizable to a broad audience and the conclusions are transferable and highly useful in a variety of settings. Case studies should also support and reference the conference theme. Case studies are 90 minutes in length.
• Skill-building workshops should present a set of tools and/or skills and clearly identify how they can be used to effect change in organizations. Skill-building workshops are 90 minutes in length.

Presenter and Co-Presenter Biographies. Please provide a short biography (no more than 70 words) for each presenter and co-presenter (do not send resumes, CVs, etc.) if you have not presented at this conference before.

By submitting this application, I (we) agree to the terms set forth in the application cover letter. We also agree that if our proposal is accepted, we will sign a partnership in quality agreement which will establish the terms of our partnership with Pegasus, enabling us to jointly create a positive learning experience for the participants of the conference.

Signature: __________________________________________

Date:___________________________

Please Note:
• Preliminary Application deadline is March 7, 2005
• Notification of first-cut acceptance or decline will be sent by e-mail on March 16.
• Final Applications are due by March 30, 2005.
• Notification of final acceptance will be made by April 13.

Pegasus Communications, Inc., Conference Department
One Moody Street, Waltham, MA 02453-5339
781-398-9700 • Fax 781-894-7079
stapresent@pegasuscom.com