ILA: Events: Conference Proposal Form

2010 Conference
Proposal Form

The deadline for submitting this form is January 11, 2010. The Conference Proposal Form is also available for download in .pdf format (requires Acrobat Reader)

Additional proposal information and the full text of the Call for Programs is also available.

Please provide correct spellings and institutional affiliations. This information will be used to prepare the Preliminary and Final Conference Program books.

I.	Your Contact Information
1.	Name
	Institution
2.	Mailing Address
	City, State, Zip

3.	Work Phone
	Work Fax
	Email

II.	Moderator's Contact Information
4.	Name
	Institution
5.	Mailing Address
	City, State, Zip

6.	Work Phone
	Work Fax
	Email

III.	Proposed Program Information
7.	Sponsor (if applicable)
8.	Working Title
9.	Track
10.	Format
11.	Program Length	60 minutes 90 minutes
12.	Preferred Slot	Rank preferred day and time (1-5):
		Tuesday 10/28 AM Tuesday 10/28 PM Wednesday 9/29 AM Wednesday 9/29 PM Thursday 9/30 AM Thursday 9/30 PM *Please note:* we will attempt to honor requests, but there is no guarantee you will receive your requested time or date.
13.	Description: In 50 words or less, describe your session using the guidelines below. Sell your session by making it sound interesting. Do not include presenters' names - they will be highlighted elsewhere. Do not use abbreviations or acronyms. Use lists whenever possible. For example, topics include . .

14.	Objectives: What three things will participants learn from this program?
	A.
	B.
	C.

IV.	Speaker Information
	List proposed speakers below. Please provide correct spellings and institutional affiliations. This information will be used to prepare the Preliminary and Final Conference Program books. See the ILA policies governing reimbursement, honoraria and speaker contracts and remember that only the ILA Office can sign a contract with a speaker. NOTE: Please include additional speaker information if speakers' qualifications/expertise for program are not obvious. The information provided on this form will be used to list your speakers' names in the preliminary conference program. Please confirm the correct spelling of their names and their name of their institution.
15.	Speaker 1
	Name
	Institution
	Mailing Address
	City, State, Zip
	Work Phone
	Work Fax
	Email
	ILA member?	yes no
	Employed in library?	yes no
	Honorarium requested?	yes - amount: no
	Travel exp. requested?	yes - amount: no
16.	Speaker 2
	Name
	Institution
	Mailing Address
	City, State, Zip
	Work Phone
	Work Fax
	Email
	ILA member?	yes no
	Employed in library?	yes no
	Honorarium requested?	yes - amount: no
	Travel exp. requested?	yes - amount: no
17.	Speaker 3
	Name
	Institution
	Mailing Address
	City, State, Zip
	Work Phone
	Work Fax
	Email
	ILA member?	yes no
	Employed in library?	yes no
	Honorarium requested?	yes - amount: no
	Travel exp. requested?	yes - amount: no
18.	Speaker 4
	Name
	Institution
	Mailing Address
	City, State, Zip
	Work Phone
	Work Fax
	Email
	ILA member?	yes no
	Employed in library?	yes no
	Honorarium requested?	yes - amount: no
	Travel exp. requested?	yes - amount: no

V.	Costs and Requirements
19.	Program Cost
	Honoraria	$
	Travel	$ ($.50/mile or coach airfare)
	Per Diem	$ ($35.00/day)
	Hotel	yes - nights: no
	Total Cost***	$
	***Excluding audiovisual and hotel costs (ILA will calculate).
20.	Audiovisual Equipment Requirements One podium microphone will be provided in each room; if additional microphones are required (floor, table, etc.), please note.
		LCD Projector and Screen (Used for presentations using a laptop computer. Please note ILA does not supply computers; presenters must bring their own.)
		Internet connection (Please consider if your program truly requires an Internet connection, as they are quite expensive. Please note that all Internet connections are wired. Wireless connections are not available.)
		Flip Chart/Pens
		Overhead Projector and Screen
		Slide Projector and Screen
		DVD Player and Monitor
		VHS Player and Monitor
		Other (describe):
21.	Room Set-up All rooms will be set theater style (rows of chairs facing a head table), unless otherwise requested. A table for handouts will be located in the rear of each room. If this program needs a special room set-up, check the requested set-up below. Please note: there are a limited number of rooms that can accommodate special room setups. We will do our best to honor requests.
	Classroom	(participants seated at long tables facing the head table)
	Rounds	(participants seated at round tables for discussion)
	Other:
22.	Funding Does your unit have any specific suggestions as to potential financial sponsors to help support this program/event?
	Contact Name
	Company
	City, State, Zip
	Phone
	Fax
	Email

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