Programming Proposal Form

Your name (first & last, including title/honorific if applicable)*

Email address*

Phone number*

What kind(s) of programming would you like to participate in?*
One-shot gamePanelPresentation/lectureWorkshop/hands-on activityOther
If "Other", please describe the format of program you are proposing:

Tell us about your proposal (guidelines available here)*

Tell us about yourself*

Any special needs (such as table space, A/V requirements, additional panelists)?

Will special materials be required for this activity?*
YesNo

Do you have a church affiliation that you'd like to share?