Proposal Submitted By

Your Name

Your E-Mail

Session Information

Session Code

Session Title

Sponsoring Commission

Commission Contact

Contact E-Mail

Day

Time

Approved By

Session Length

Anticipated Attendance

Program Description for Session

(Please include the type of program you are presenting - i.e. panel, working meeting, discussion, etc. Limit: 500 characters)

Personnel Information *

Session Chair

Non-USITT **

Address

 

 

 

Phone (Work)

Phone (Home)

Fax

E-Mail

Additional Panelists

Panelist 1 Name

Non-USITT **

Address

Phone (Work)

Phone (Home)

Fax

E-Mail


Panelist 2 Name

Non-USITT **

Address

Phone (Work)

Phone (Home)

Fax

E-Mail


Panelist 3 Name

Non-USITT **

Address

Phone (Work)

Phone (Home)

Fax

E-Mail


Panelist 4 Name

Non-USITT **

Address

Phone (Work)

Phone (Home)

Fax

E-Mail


Panelist 5 Name

Non-USITT **

Address

Phone (Work)

Phone (Home)

Fax

E-Mail


Panelist 6 Name

Non-USITT **

Address

Phone (Work)

Phone (Home)

Fax

E-Mail

* Please submit program participant's biographies form for all panelists and forward to Commission Contact Person. Maintain a copy of each form for your records.

** Checking the 'non-USITT' box does not generate the Non-Member Guest registration. You must complete the Non-Member Guest registration form for non-member presenters, unless you are also requesting housing or travel for that guest.

Requirements

Room Configuration

Note: Theatre/Panel is the standard configuration.

Theater/Panel
Theater / Panel
Classroom
Classroom
Hollow Square
Hollow Square
# of Presenters /
Participants
Reception
Reception Layout
Tables along
walls
Tables Along Walls
# required
Other

Describe
your needs
in the notes
area below.

Notes

Technical Requirements

A/V Equipment is EXPENSIVE. Please be sure of your requirements.

Computer Stand Alone DVD Player Props / Other (specifiy below)
    PC   or MAC Slide Projector
    USITT supplied  or Personal Overhead Projector
    Internet Video Camera
    Audio Playback Laptop VHS
  White Board