Programming Submission Form

Panel Point of Contact

First

Last

This person will receive all communication from Shore Leave regarding your presentation and will be responsible for notifying fellow panelists of additional information sent out throughout the application process.

program? Contact required

Email

Contact Phone Number

No dashes, just numbers.

Panel Description

If your panel is chosen, this will be used for our program guides. Shore Leave reserves the right to edit this description should it feel necessary (25 words or less).

Proposed Program Title (10 words or less)

Format

If you chose "Other" for your format, please explain

Preferred Day/Time

Is there a Day/Time when you CANNOT host?

Have you previously presented this program, or a variation of it, at other meetings, conferences or conventions?

Yes
No

If so, in what year and where did you previously present this program?

Does your program have an attendance limit?

Yes
No

If yes, what is the limit and why?

What rating would be applied to your program?

Rated G
Rated PG-13
18+ (requires an ID check)

Do you plan to use media during your presentation?

Yes
No

Shore Leave will provide AV support within reason. We do not have extra laptops, but will do our best to have projectors and sound equipment for the panels as long as their is prior notice.

If yes, what do you plan to show or play?

Do you have all required permissions for the video and audio clips in your presentation?

Yes
No

Moderator Name

First

Last

If you have planned additional presenters, please provide the information below including the moderator. It is not necessary for you to have a planned slate of presenters to submit your program idea. Shore Leave reserves the right to assign/re-assign presenters to all programs as best serves the overall meeting needs.

List all other program participants

Additional Comments that you want to share with the Shore Leave Programming Team

TERMS AND CONDITIONS

I agree

I understand that this application does not guarantee me a programming slot at Shore Leave Convention and only registers my request to stage a program at the event. I understand that, if my program is accepted, I acknowledge that as a designated Fan Panelist I would have to purchase admission to the convention to present. I will abide by all Shore Leave Convention policies if my program is selected. I also understand that, if accepted, Shore Leave Convention reserves the right to adjust the time and/or location of my programming at any time and that Shore Leave Convention may also decide to combine my program idea with other similar ideas to best serve the needs of the overall convention. By submitting this application, I am agreeing to all terms and conditions as stated above by either typing my name, digital signature or manual signature.