Convocation Breakout Session/Meeting Request Form

Fall 2014 Convocation:

Please direct questions about the form to Robin Craig or Ann MacLaughlin-Berres at the CETL office, (608) 246-6646, rlcraig@madisoncollege.edu.

Please give your session or meeting a title that accurately describes the objectives.
Tuesday, August 26th
The Tuesday morning breakout sessions will cover college-wide issues such as Shared Governance or Faculty Quality Assurance. If you have a suggestion for a breakout session at this time please discuss with Patrick Barlow in CETL, 608-246-6646 before requesting this time slot.
Tuesday afternoon has been reserved for school and unit meetings. Please enter your preferred time here and preferred room in the space below, however, please note that there are very limited large meeting spaces available.
Wednesday, August 27th
Please select the times that you would like to offer your session. If you select more than one time please indicate in the notes section whether you would like to offer the session only once or multiple times.
Please add any additional comments about your session or meeting in the space above. You may indicate the time of your meeting or session if it does not fit one of the above times. If you would like to offer your session multiple times please indicate that here.
(Be specific about topic, focus and intended audience)
(Approximate number of people you can accommodate for this session or that you expect to attend.)
If you have a specific room request or type of room please enter that above. Please note that large spaces are very limited and in high demand during Convocation. We will try to honor specific requests as much as possible.
Please describe the room set up you desire. Please be aware that most of the rooms available are classroom style with tables and chairs. We will do our best to accommodate your needs.
Please use the space above to describe any technology or equipment not listed above that you might need.
If you would like CETL to copy handouts for you, please send PDF or Word documents as an attachment to Robin Craig, rlcraig@madisoncollege.edu. Please include any special instructions. All handouts will be printed black and white, doublesided unless you indicate otherwise.
If you cannot attach handouts now, you can email them at a later date (up to one week before Convocation) to Robin Craig.
Anything else you think CETL staff may need to know about your session can be typed into this space.
Presenter or Requestor Contact Information
External Speaker Information Request
If you are an external presenter (not a Madison College employee) please include your address and Federal Tax ID number or Social Security Number.
If you are an external presenter (not a Madison College employee) please include your address and Federal Tax ID number or Social Security Number.