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MN Adult Ed
MN ABE Connect
Presenter Form – Metro Regional
NOTE: This form serves as your registration for this event.
Please do not register as a participant
in addition to submitting this form.
Date
*
MM slash DD slash YYYY
Presenter Information
Name
*
First
Last
Email
*
Enter Email
Confirm Email
Phone
*
Your Organization
*
Your Title
*
For example, ESL Instructor
Dietary restrictions/allergies that we can accommodate:
(If you have other dietary requirements, please feel free to bring your own food.)
Gluten-free (for those with medical restrictions or allergies only)
Dairy-free (for those with medical restrictions or allergies only)
Vegetarian
Peanut allergy
Other nut allergy
Multiple restrictions - will receive Garden Vegetable salad with vinaigrette
NON-dietary needs (to be accommodated to the best of our ability):
NOTE: Gail Rutan will email you directly about these needs.
Session Information
Title of workshop you are presenting:
*
Are you the designated Lead Presenter for this session?
*
Yes
No
LEAD PRESENTERS: Please provide a brief workshop description (up to 200 words).
*
LEAD PRESENTERS: Please list the name(s), email(s), and organization(s) of your co-presenter(s), if applicable.
Co-Presenter/Panelist Name
Organization
Email
Role (co-presenter or panelist?)
Your meeting room will have a projector, screen, microphone, speakers, flip chart, markers, and wifi. You are responsible for bringing your own laptop. Is there anything else you need for the success of your session?
*
Yes
No
Please explain:
*
Are you planning any special activities during your session? (Gail Rutan will contact you to discuss the details.)
*
For example, video conferencing, videotaping, computer stations, etc.
Yes
No
Please describe the special activity you have in mind.
*
Your meeting room will be set with round tables. Do you have any of the following additional needs?
*
Panel discussion head table
Presenter table in addition to the AV cart
No special preferences
Other room set-up preferences (NOTE: We will do our best to accommodate you but may be limited):
Do you need ATLAS to make photocopies for you?
*
NOTE: Documents must be emailed as PDF or Word attachments (not Google Docs) to Gail Rutan by MONDAY, FEBRUARY 19. Sorry, no exceptions.
Yes (documents must be emailed as attachments by MON. FEB. 19)
No
What materials or equipment, if any, do you want participants to bring to the event? (for example, CCRS books, laptops, etc.) Please be specific, as this will be included in participant communications.
NOTE: If participants should bring laptops/devices, be sure to include this in your session description.
Are you presenting another session?
*
Yes
No
Title of workshop you are presenting:
*
Are you the designated Lead Presenter for this second session?
Yes
No
LEAD PRESENTERS: Please provide a brief workshop description for this second session (up to 200 words).
*
LEAD PRESENTERS: Please list the name(s), email(s), and organization(s) of your co-presenter(s) for this second session, if applicable.
Co-Presenter/Panelist Name
Organization
Email
Role (co-presenter or panelist?)
Your meeting room will have a projector, screen, microphone, speakers, flip chart, markers, and wifi. You are responsible for bringing your own laptop. Is there anything else you need for the success of your session?
*
Yes
No
Please explain:
*
Are you planning any special activities during your session? (Gail Rutan will contact you to discuss the details.)
*
For example, video conferencing, videotaping, computer stations, etc.
Yes
No
Please describe the special activity you have in mind for this second session.
*
Your meeting room will be set with round tables. Do you have any of the following additional needs?
*
Panel discussion head table
Presenter table in addition to the AV cart
No special preferences
Other room set-up preferences (NOTE: We will do our best to accommodate you but may be limited):
Do you need ATLAS to make photocopies for you?
*
NOTE: Documents must be emailed as PDF or Word attachments (not Google Docs) to Gail Rutan by MONDAY, FEBRUARY 19. Sorry, no exceptions.
Yes (documents must be emailed as attachments by MON. FEB. 19)
No
What materials or equipment, if any, do you want participants to bring to the event? (for example, CCRS books, laptops, etc.) Please be specific, as this will be included in participant communications.
NOTE: If participants should bring laptops/devices, be sure to include this in your session description.
Additional Needs or Instructions:
Contact Us
Gail Rutan
Senior Events Manager
[email protected]
