Facutly Presenter Information Profile

Michigan Seminars in California
Thursday, April 8, 2010
Email address: (REQUIRED)

 

Presenter Name:

 

Registered By:
(if other than presenter)

Campus Address:


Campus Zip:


Campus Phone:


Cell Phone:


Assistant Name:

Assistant Email:

Assistant Phone:

   

Audio/Visual Needs

 
Please select all presentation equipment you will be requiring:
LCD Projector

Laptop Computer-Mac

Laptop Computer-PC

Screen
Lectern

Overhead Projector

VCR/TV

Other: 
 
Please select all sound amplification equipment you will be requiring:
Stand Microphone

Cordless Lavaliere Microphone

Tabletop Microphone

Cordless Handheld Microphone

Lectern Microphone

Other: 
 

Power Point Presentation

Will you be using Power Point to convey your presentation message?


If so, the Office of University and Development Events would like a copy of the presentation on CD in order to preload the presentation on laptops at each seminar location.
Please list the name of the person to be contacted in order to make delivery arrangements:


 

Co-Presenters, Panelists, Students, Performers

Please list the names of co-presenters, panelists, students, or performers as well as a short bit of information about them.
Name:

Affiliation:



Email:

Additional information

  ie., professorship, year in school, title
   
Name:

Affiliation:

Email:

Additional information

  ie., professorship, year in school, title
   
Name:

Affiliation:

Email:

Additional information

  ie., professorship, year in school, title
   
Name:

Affiliation:

Email:

Additional information

  ie., professorship, year in school, title
 

Dietary Restrictions

Please list any dietary restrictions that we can accommodate:


 

Mobility Concerns

Do you have any mobility concerns? What type of accommodations can we make for you?


 

Travel

The Office of University Development will reimburse all qualifying financial obligations associated with your participation in the Michigan Seminars up to the U-M limits. Please make your own flight and ground transportation arrangements. Please register your hotel needs.

San Francisco Hotel Needs

*Recommended dates of stay April 7, 2010 – April 9, 2010

Hotel: Stanford Court Hotel
905 California Street
San Francisco, CA 94108
(415) 989-3500

Number of guests in room

Check-in date

Check-out date

Room type

 

Confirmation Packets

You will receive a confirmation packet approximately 2 weeks prior to the event. This packet will include driving directions and maps to/from site, a program schedule, and travel forms.
 
Submit your registration:  
   
If you have any questions please email Jenny Freels at freels@umich.edu or call 615-1997.

The University of Michigan Office of Development, 3003 South State Street, Suite 9000, Ann Arbor, MI 48109-1288phone734 647-6000