PROGRAM / BUSINESS MEETING PROPOSAL FORM
2006 ULA ANNUAL CONFERENCE

Dixie Center, St. George, Utah
May 17-19, 2006

DEADLINE Tuesday, November 15, 2005
[Proposals must be received by noon on this date. No exceptions.]


Instructions:
  • Submit a separate form for each program you are proposing.
  • Obtain all the information necessary to submit a complete and accurate proposal before you begin filling out this form.
  • Take a few minutes before submitting your proposal to read the Guide for ULA Program Planners and Guide for ULA Program Speakers. Provide your speaker(s) with a copy or link to latter. ("Program Planning Guides")

FYI:
Though an Internet connection is available for program sessions connectivity cannot be guaranteed at the time of or during a presentation.
Internet connections are not available for use in conjunction with Poster Sessions or Table talks.
Poster Sessions will be in the foyer of the Dixie Center with no added security.


Contact Information

What is your Name:
What is your Email Address:
What is your day-time telephone number:

 


Program Information

What is the name of the ULA Section/Sponsor for this program:   

What type of program are you proposing:

1 hour Conference Session
2 hour Conference Session
3+ hour Pre conference Session


Do you require two consecutive time slots to provide
for discussion following the presentation:

 
Yes No

Preferred Program Date(s):

Wednesday, May 17
Thursday, May 18
Friday, May 19 (Post-conference)

Who is the target audience for this program:

Select target Audience

To what track does this program belong:

Select track

What is the title of your program:  

Provide a brief (Maximum 240 characters) description of program content, purpose, and objectives. [Note: What you provide below will be the description that appears in the Conference program.]

What is the Presentation Format:

Single speaker
Multiple speakers
Panel discussion
Demonstration

Additional comments or information to accompany your proposal (Maximum 240 characters):


Speaker(s) Personal Information

Provide the following information each speaker

No. 1 Name:
  Title:
  Institution:
  Email Address:
  Home Mailing Address:
  Daytime Phone Number:

No. 2 Name:
  Title:
  Institution:
  Email Address:
  Home Mailing Address:
  Daytime Phone Number:

No. 3 Name:
  Title:
  Institution:
  Email Address:
  Home Mailing Address:
  Daytime Phone Number:

No. 4 Name:
  Title:
  Institution:
  Email Address:
  Home Mailing Address:
  Daytime Phone Number:


If more than 4 speakers, please list them down below (Maximum 400 characters):

Do you wish to schedule a business meeting with this program:   Before After


Compensation Request

[NOTE: Only speakers not affiliated with ULA are given financial compensation.
Round trip transportation from Las Vegas International Airport to the Shuttle Lodge Inn (1 mile from the Dixie Center) is $55.00 per person using the St. George Shuttle Services.]

Speaker fee/honorarium: $
Travel $
Lodging: $
Meals: $
TOTAL: $
Matching funds amount: $
Source of Matching Funds:

 


Facilities and Equipment

Room Set Up
[Note: Standard set up includes, 1 Draped Table (seats 4), 1 Podium, seating for 50 (with tables),100 (without tables). Standard setup is a classroom configuration with tables in the first three rows. Set up other than classroom or panel configurations need to be return to the original configuration afterward. This will be your responsibility.]

Classroom (with tables)
Classroom (without tables)
Classroom (mixed)
Panel discussion
Other

Equipment Needs
[
NOTE: ULA cannot provide computers or software for presentations. It is up to the speaker/sponsor of the program to do so and to ensure their equipment is compatible with any equipment or internet connection provided at the conference facility. Though Internet access is available, there is no guarantee regarding connectivity or speed. Each meeting room is equipped with a single lavaliere microphone and/or single handheld microphone with stand, and a projection screen.]

Absolutely no equipment needed for this presentation, including projection equipment or computer access

It is expected that yourrequest will reflect "actual" rather than "supposed" needs. Which of the following items will definitely be used during the presentation of this program:

Will you be needing an internet connection for your presentation?

Yes
No

Which of the following, if any, do you or the speaker intend to bring for use in this program?

Laptop computer
LCD computer projector
CD player
DVD player
VCR player
Slide projector
Other:

Thank you for submitting this proposal!