Seminar Leader Information

Presenter Name (Required):

Badge Name:

E-mail (Required):

Postal Address:
Street:
City:
State: 
Zip/Postal Code:
Country (if not USA):

Phone (Required):

Additional Speakers -
(please include Name, Nickname, Address and Email):


Scheduling Information

Length of Seminar (Hrs):

Times I want to talk:
 (e.g., 2PM-6PM Sat)

Times I can't talk:
 (e.g., 2PM-6PM Sat)

Teen Room EventL
Kid's Room Event:
 
Seminar Information

Seminar Title:

Program Book Description 
 (30 words maximum)

Website Description
 (no real upper limit to word-count):

URL:

Additional information for the scheduler (This will NOT appear in the program book or website):