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2. 2013 MMASC Annual Conference: May 22-24, 2013
   
4. Fess Parker's Doubletree Resort, 633 E Cabrillo Blvd., Santa Barbara, CA
8. SPEAKER INFORMATION
10. First Name
11. Last Name
13. Organization
14. Title
16. Address1
18. Address2
20. City
21. State
22. Zip
24. Cell Phone Number
25. Email Address
27. Speaker Bio (for Introductions)
29. Upload Speaker Bio
30. Upload Speaker Headshot Photo
    Recommended: 200 x 150 for landscape and 150 x 200 for portrait
34. SESSION INFORMATION AND SPEAKER REQUESTS
36. Your Moderator:
    The Conference Committee will assign a moderator to your session. The moderator will provide the speaker introduction(s) and assist in facilitation. As moderator, they will contact you in advance of the Conference to schedule a conference call for all session speakers so the speakers may become acquainted with one another and to provide for a well-coordinated session.
38. Session Details:
    In order to accommodate the maximum number of attendees, all breakout sessions will be set-up classroom style, while all general sessions will be set-up with several round tables. If necessary, handouts must be provided by the speaker. Please also submit an electronic version of your presentation (pdf or ppt) to your moderator by May 3, 2013, so it can be available to attendees via the MMASC website and agenda. Microphones and projectors with screens will be provided, however laptops and an Internet connection will NOT be provided. Please indicate any additional or specific A/V requests below. MMASC will try to accommodate you.
40. Session Title
42. Session Description:
44. Session Date/Time
    Session Date/Time

    Session Date/Time
45. Session Track:
    -- Select One --Leadership TrainingCareer Advancement PlanningSkill Building
47. Speaker Needs:

    1. Projector for a PowerPoint Presentation
    2. Other (please specify any special needs below)
49. Conference Participation:

    In return for your participation, MMASC invites you to join us for lunch on the day you are speaking. Please indicate below if you will be joining us for lunch. Please also indicate if you have special dietary restrictions.

    1. I will be attending lunch on Wednesday, 5/22/13 from 1:30 p.m. - 2:15 p.m.
    2. I will be attending lunch on Thursday, 3/23/13 from 12:00 p.m. - 1:30 p.m.
    3. I will be attending lunch on Friday, 5/24/13 from 11:30 a.m. - 1:00 p.m.
    4. Since I am already registered for the conference, I am already included in the lunch count.
    5. I regretfully decline the offer for lunch.
    6. I require a vegetarian, gluten free, or other type of meal.
51. Accomodations, Expenses, and Special Requests:
    No expenses incurred by the speaker in relation to preparing for or traveling to the 2013 MMASC Annual Conference will be reimbursed by MMASC unless identified in this speaker agreement AND otherwise agreed to in advance by the MMASC President. Please indicate any special or accommodation requests you have below and you will be contacted by the MMASC President.
53. Please identify any special requests:
57. REMINDERS AND ACCEPTANCE OF AGREEMENT
59. Deadlines:
    By March 29, 2013, return/submit this speaker agreement and a bio and headshot. (Note: only General Session speaker bios and headshots will be published in the Conference program. Other speakers will appear on the MMASC website. By May 3, 2013, provide an electronic version of your session's presentation (pdf or ppt) to your moderator.
61. Acceptance of Agreement:*

    I certify that understand that I am to arrive to the Conference venue no later than one hour before my presentation. Upon arrival I know to report to the Registration table to check-in and obtain my badge and Conference details. By submitting this form, I am indicating my concurrence with the terms of this Speaker Agreement.

    1. I understand and agree.

    1. I do not agree.
Leave This Blank:


63. 1. Receive an email copy of this form.
64. Email address

    This field is not part of the form submission.

65. Submit Submit and Print

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