Media Site Reservation

RESERVATIONS MUST BE MADE AT LEAST 24 HOURS IN ADVANCE AND BE PRE-APPROVED BY LIFESPAN LEARNING INSTITUTE.

Contact Information:

Lifespan Department: (required)

Your Name (required)

Email: (required)

Phone: (required)

Primary Presenter Details:

Presentation Title (required)

Presenter Name (required)

Bio URL: (required)

Email: (required)

Presenter Photo: (required)
photos must be 60x80 pixels

Secondary Presenter Details:

Presentation Title:

Presenter Name:

Bio URL:

Email:

Event Information:

Date of Event: (required)

Start Time of Event: (required)

End Time of Event: (required)

Host Location: (required)

Extra Information:

Will the Presenter be using their own computer? (NOTE: If using a MAC, you need to bring your VGA adapter)
I will use a computer already in the room.I will use my own laptop.No computer will be used.

Additional Comments/Requests (such as extra microphones, etc.):

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