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WORKSHOP/CONFERENCE/PROFESSIONAL DEVELOPMENT PLANNING FORM
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Type of Event:
1-day conference/workshop
multi-day workshop series
group professional development session
consultative services by Hofstra faculty
Name:
Your answer
Title:
Your answer
School/Organization:
Your answer
Work phone:
Your answer
Cell phone:
Your answer
Email:
Your answer
INFORMATION ABOUT THE PROPOSED EVENT
Title:
Your answer
Description of Event:
Your answer
Proposed Dates
Please list 1st, 2nd and 3rd choices.
1st Choice:
Your answer
2nd Choice:
Your answer
3rd Choice:
Your answer
Estimated # of Attendees:
Your answer
Start Time of Event:
Your answer
End Time of Event:
Your answer
Meals/Food
Please select.
BREAKFAST:
Yes
No
Clear selection
LUNCH:
Yes
No
Clear selection
OTHER FOOD:
Yes
No
Clear selection
OTHER FOOD, if "yes":
If you have marked "yes," please describe:
Your answer
Facilities:
We need access to a theatre-type setting for a large group sessions:
Yes
No
N/A
Clear selection
We need access to break-out rooms for small group sessions:
Yes
No
Clear selection
We need access to break-out rooms for small group sessions - If “yes,” how many? :
If you have marked "yes," please note how many rooms will be needed.
Your answer
We would like this event to take place at another location (describe):
Please describe.
Your answer
Audio-Visual Services:
Presenters will need access to projectors and screens for PowerPoint presentations.
Yes
No
N/A
Clear selection
Other audio-visual needs (please describe):
Your answer
Special Event Needs:
Please describe any special arrangements needed for a successful event.
Your answer
As a representative of the organization listed above, do you wish to co-sponsor this event with Hofstra?
Yes
No
Clear selection
If “yes,” can your organization provide a liability insurance coverage certificate?
Yes
No
Clear selection
Do you wish to issue certificates to attendees to include the number of contact hours for participants?
Yes
No
Clear selection
In order to keep costs lower to attendees, do you have any donors able to help defray costs?
Yes
No
Clear selection
SUBMIT THIS FORM! An OPDS Representative will contact you within three business days.
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