|
| Program Title * |
|
| Speaker Name * |
|
| Title * |
|
| Organization * |
|
| Speaker Email * |
|
| Will ALSC need to order a one-day speaker badge? (approval required) * |
Yes
No
|
| Is the speaker an author/illustrator? * |
Yes
No
|
| If the the speaker is an author/illustrator, is his publisher funding? |
Yes
No
|
| Special Requests/Additional Comments |
|
Speaker #2
|
| Speaker Name |
|
| Title |
|
| Organization |
|
| Speaker Email |
|
| Will ALSC need to order a one-day speaker badge? (approval required) |
Yes
No
|
| Is the speaker an author/illustrator? |
Yes
No
|
| If the the speaker is an author/illustrator, is his publisher funding? |
Yes
No
|
| Special Requests/Additional Comments |
|
Speaker #3
|
| Speaker Name |
|
| Title |
|
| Organization |
|
| Speaker Email |
|
| Will ALSC need to order a one-day speaker badge? (approval required) |
Yes
No
|
| Is the speaker an author/illustrator? |
Yes
No
|
| If the the speaker is an author/illustrator, is his publisher funding? |
Yes
No
|
| Special Requests/Additional Comments |
|
Speaker #4
|
| Speaker Name |
|
| Title |
|
| Organization |
|
| Speaker Email |
|
| Will ALSC need to order a one-day speaker badge? (approval required) |
Yes
No
|
| Is the speaker an author/illustrator? |
Yes
No
|
| If the the speaker is an author/illustrator, is his publisher funding? |
Yes
No
|
| Special Requests/Additional Comments |
|
Speaker #5
|
| Speaker Name |
|
| Title |
|
| Organization |
|
| Speaker Email |
|
| Will ALSC need to order a one-day speaker badge? (approval required) |
Yes
No
|
| Is the speaker an author/illustrator? |
Yes
No
|
| If the the speaker is an author/illustrator, is his publisher funding? |
Yes
No
|
| Special Requests/Additional Comments |
|
|
