ASAPA presents

Animethon 26

Aug 9 - 11 / 2019 Edmonton Convention Centre Edmonton Alberta Canada

Panel Form

Contact Information
Please provide the following information as shown on your government issued photo ID:

First name:

Your legal given name as on government issued ID

Required
Last name:

Your surname as on government issued ID

Required
Preferred name:

How would you like to be addressed?

Optional
Email:

A valid email address so we can contact you

Required
Phone:

Your preferred phone number

Required
Home city:

Please let us know where you're from

Recommended
Event Information
Alias:

Name to print in the guidebook (your own name, alias, group name)

Optional
Event name:

Your event name or title

Required
Event type:

What is your event format?

Required
Rating:

Please refer to Appendix A in the Panel Guidelines for rating descriptions

Required
Duration:

How long will your event run?

Required
Room size:

Room size not guaranteed, but we will try our best to accommodate

Optional
Room layout:

Not guaranteed, but we will try our best to accommodate

Optional




Tell us about your Event or Panel:
Please provide a detailed explanation of your idea, what you wish to do, how you will engage your audience. All information provided will be used for selection process Required

Short Description (150 characters max):
Please provide a short description for the printed guidebook Required
Co-Panelist Information
If you have a co-panelist please provide their details here. One co-panelist only please.

Co-panelist:

Do you have a co-panelist (one) assisting you?

Required
Yes No


Additional Information
We will NOT provide laptops. Panelists are expected to bring their own equipment (please submit specifics in the Tell us about your Event or Panel   box above for approval).

Setup help:

Request Tech Assistance for setup at Convention?

Required
Yes please No thanks
Audio required:

Audio (for any device with audio-out)

Required
Yes please No thanks
Video required:

Video (HDMI/VGA devices)

Required
Yes please No thanks
Time conflicts:

Are you involved with another event (eg Cosplay) or hosting another panel?

Required
Yes No


Additional Information:
Any other details you would like us to know? Such as personal experience, social media references or other useful information for us to consider for panel selection?
Recommended
Availabilty Information
Your availability:
When would you be able to hold your panel? Morning is 9:00 AM to 12 noon, afternoon is 12 noon to 6:00 PM and evening is 6:00 PM to 12 midnight
Friday: Morning Afternoon Evening All Day
Saturday: Morning Afternoon Evening All Day
Sunday: Morning Afternoon Evening All Day
Required
Signature of Event Host
By checking this box, you agree to abide by all Animethon policies polices and have read, understood and agree to abide by the Panel Submission Guidelines and Rules.

Once your submission is received, a confirmation email will be sent to the email provided above. Please review to ensure all information provided is correct.

If you need to correct any information on this form, email live@animethon.org. Do not resubmit this form. Thank you.

Signature

Use finger or mouse to sign recognisably, use the whole area.
Clear


Printed:

Please type your name

Required


Date:

Date





Required We require this information in order to proceed.
Recommended While we do not require this information it would definitely assist us which could in turn help you.
Optional We do not require this information but we may find it helpful.