ATLAS VIRTUAL Event Presenter Form

Date*
MM slash DD slash YYYY
Your Name*
First Last
Your Email*
Enter Email Confirm Email
Cell Phone*
Only for use by administrators on the day of the event, in case of emergencies or tech issues
Your ABE Program/Consortium/Site*
OTHER: If not listed above, what is your ABE program?*
Virtual Event Details
Virtual Event Title*
(e.g., ACES Webinar, CCRS Webinar, Math Webinar, etc.)
- ACP Institute
- Math Institute
- Fall Statewide Conference
- Spring Statewide Conference
Virtual Event Time*
(e.g., 1:30-3:00 pm)
Virtual Event Date*
MM slash DD slash YYYY
Title of Your Session/Webinar*
(for events without multiple sessions, this may be the same as the Event Title)
What is your role in the presentation?*
- Lead Presenter/Facilitator
- Co-Presenter/Facilitator
- Panelist
Please provide a description of your session/webinar (approximately 3-5 sentences).*
It is your responsibility as Lead Presenter to inform Gail Rutan directly of any changes after your presenter form has been submitted.
Do you have any co-presenters and/or panelists?*
- Yes, I have co-presenters and/or panelists.
- No; I am presenting alone.
Please list the names and emails of all your co-presenters and/or panelists. [CLICK PLUS SIGN ON RIGHT TO ADD MORE ROWS]*
It is your responsibility as Lead Presenter to inform Gail Rutan directly of any additions/deletions/changes after your presenter form has been submitted.
First & Last Name Email Organization Presentation Role (i.e., co-presenter, panelist, table coach, etc.)
Will you need to receive a registration list before the event?*
- Yes
- No
By when will you need the registration list?*
Additional Instructions
Additional instructions or questions for Senior Events Manager Gail Rutan: