MAFAA Conference Planning Committee

Online Interest Session Information Form

Please fill out the form. The information will be mailed to the Conference Planning Chairperson.

Conference: (required)
Name of Session:
Date of Session: (required)
Time of Session: (required)
Description of Session:
"Final description for Agenda"

Presenter 1 Information
Name: (required)
Title:
School/Business:
Street Address:
City, State, Zip:
Phone with area code:

Presenter 2 Information (if needed)
Name:
Title:
School/Business:
Street Address:
City, State, Zip:
Phone with area code:
Audio/Visual Needs:
(check all that we need to provide)		 Overhead Projector
LCD Projector
Screen
VCR
Podium Microphone
Lapel Microphone
Internet Connection

Moderator Information
Name:
Title:
School/Business:
Street Address:
City, State, Zip:
Phone with area code:
Other Arrangements and Details:
(fees, lodging, meals, transportation, etc. and who will pay for these?)
Submitted by:


The data from this form will be emailed to the Conference Planning Chairperson.

Print out the next page and keep a copy for your records.