PTI Conference Speaker Application


    Please submit ideas and topics for the Winter 2021 PTI Mini Conference to be held on December 4th 2021 from 1 to 5PM PST in San Jose, CA. The theme of the conference is "Heading into the Storm: Trauma Informed Experiential Pscyhotherapy."

    Deadline for the December miniCon is Friday, October 16th, 2021.

    If you have multiple proposals, submit one form per proposal.

    All workshops and panels will offer CEU's. For each workshop or panel, speakers are required to include a brief description, learning objectives and bio. If you would like assistance in formulating your speaker proposal, please email

    Please remember to save a local copy of your proposal before hitting the submit button.


    Your Name: (required)

    Your BBS Registration Number: (required)

    Your Email: (required)

    Your Phone (required):

    How would you like to participate (required):
    I would like to offer an experiential workshopI would like to offer a panel discussion that I will organize and moderateI am open to participating in a panel discussion that someone else is organizingOther, please give a short description below

    Your own idea for participation:

    Title of Your Proposed Workshop or Panel:

    A Brief Description of Your Workshop:

    Learning Objectives for Your Workshop:

    A Brief Professional Bio (please highlight your PTI training):

    Before hitting submit, save a local copy in case there is an error and you have to resubmit your form again! If you need assistance, email

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