Abstract Form

Please submit by email no later than 15 November 2010 to kevin@seameo-spafa.org, girard@seameo-spafa.org

Applying for sponsorship? YES NO

Your Name:

Nationality: Age:

Title of Presentation:

Theme: please indicate A B C D

A) Poverty & Conflict B) Health

C) Environment D) Energy & Development

Format of Presentation:

Please indicate the format of the presentation. Dimensions for photographic or poster exhibitions is that each image should
be A2 landscape size.

If planning a presentation using film or performance please indicate what technical equipment will be required.
Abstract (200 words maximum)
Bio-data (150 words maximum)