Programming Submission Form
Panelist Information
Primary Panelist's Real Name *
Use the name on your government issued ID. If we are unable to verify your registration status, we will not be able to schedule your panel.
Your answer
Primary Contact E-Mail *
Use an email where we can reach you if there are any questions and double check to make sure it's entered correctly! (e.g. mkusanagi@section9.gov)
Your answer
Please verify your Primary Contact E-Mail Address again. *
Your answer
Primary Panelist's Alias *
Complete this if you would like to be listed under a different name in the Programming book and online schedule.
Your answer
Are you currently registered for Anime Detour? *
The primary panelist MUST be registered at the time the panel request is submitted.
Required
Next
Never submit passwords through Google Forms.
This form was created inside of Anime Twin Cities, Inc..