To be submitted to the Conference Director Monica McAbee and the MLA office, by December 31, 2010. All fields are required.

Program Title

Assigned Room

Day and Time

Program Contact

Contact Name

Email

Phone

Fax

Are you supplying your own equipment? Yes No If Yes, you are responsible for equipment storage.

Equipment Requested - There is a screen and podium microphone in each room

Lavaliere Microphone
Flip Chart, If Yes, how many:
DVD Player
Video Projector (laptop/DVD player)
Internet Access
Laptop (PowerPoint, Excel, Word, Adobe Reader, Windows Media Player, Real Player, Flash)
Additional Equipment (Please enter items below)

Room Setup

Theatre Style (Default configuration. Provides maximum seating)

Banquet Style (round tables)

Classroom Style

Please verify all information before submitting this form. Thank You.