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AC17 Speaker Information Form
Please enter information about your accepted ALSC program speakers no later than April 13, 2017. If you have more speakers than this form allows, please submit the form twice. Please contact ALSC Program Coordinating Committee Chair Eva Volin (emvolin@gmail.com) with questions.
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