zArchived - ConQuesT KC

Select Form*

Name*

First Last

Please enter your real name here. You may enter your Character Name (Badge Name) in that field.

Email*

Title Of Panel*

Choose All Categories That Apply To This Panel*

Describe Your Panel Idea*

Choose Type Of Program Item

How Would You Prefer To Populate Your Panel?*

Panelists will be assigned by ConQuesT (Select if you would like programming to select the panelists)
Submitter is the only panelist (Select if you will be the only person on this panel)
Suggested panelists listed below (If you have specific people you would like on this panel please indicate below)

Would You Be Willing To Moderate This Panel?*

Yes (Please Fill Out The Panelist Application)
No

(Please read the moderator responsibilities on the ConQuesT website)

Would You Like To Be a Panelist On This Panel?*

No
Yes (Please Fill Out The Panelist Application)

(Please read the panelist responsibilities on the ConQuesT website)

Panelist Suggestions For Panel Idea

(Not a guarantee they will be placed on the panel)

Anything Else We Need To Know About Your Panel?

Phone*

Badge Name*

Preferred Name For Program Book*

Your Facebook Page URL

Your Twitter Handle

Your Website URL

Have You Purchased A Membership To This Year's ConQuesT?*

Yes
No

Do We Have Permission To Share Your Contact Information With The Moderator For Any Panels You Are On?*

Yes
No

On How Many Panels Would You Be Willing To Participate?*

1-2
3-4
5+

(Panels are scheduled for one hour with 30 minutes between each panel)

List Any Events Or Panelists You Don't Want To Be Scheduled Against*

Are You Willing To Be Scheduled On Back To Back Programs?*

Yes
No

Are There Any Individuals You Don't Want To Be On A Panel With?*

(This information will be kept confidential and is for programming use only)

If You are An Author Would You Like To Do A Reading?

Yes
No

What Time(s) Of The Day Are You Available on FRIDAY, MAY 28th?*

Available All Day
Afternoon (Noon - 5PM)
Evening (5PM - 9PM)
Night (9PM - Midnight)
Not Available

What Time(s) Of The Day Are You Available on SATURDAY, MAY 29th?*

Available All Day
Morning (10AM - Noon)
Afternoon (Noon - 5PM)
Evening (5PM - 9PM)
Night (9PM - Midnight)
Not Available

What Time(s) Of The Day Are You Available on SUNDAY, MAY 30th?*

Available All Day
Morning (10AM - Noon)
Afternoon (Noon - 5PM)
Evening (5PM - 9PM)
Night (9PM - Midnight)
Not Available

Please Choose Your Relevant Interests And/Or Expertise Areas*

Please Briefly Describe Your Relevant Expertise*

Please Provide A Short Biography About Yourself For Our Program Book*

Please Supply Any Other Pertinent Information Here

Please List Any Years That You Have Been a ConQuesT Panelist

Please List Any Other Conventions You Have Been A Panelist At

Type of Entry*

Level*

Assembled Costume or Hand-Made*

Programming Form