HRPC Panelist Application Form
Thank you for your interest in being a part of the High Roller Pony Con panels! We are looking for lots of fun and entertainment for our guests, and want to showcase the splendor that is Las Vegas. Please fill out the form as accurately as possible. If there is a part you are uncertain of, or wish to add additional information, please utilize the "Notes" section at the end of the application, or email us at
Applications will close 3 months prior to the convention (March 1st, 2018).
First and last name
Please List All Members of Panel (If applicable)
Name of Your Panel
Please Describe your Panel
What is the anticipated duration of your panel?
If you have a link to a previous panel, example of your work, etc please link here.
What is the Audience Age for this Panel?
All Ages/Family Friendly
Do you require high power/surge protection? (Above 115V 15A A/C, or 1700 Watts)
Yes (High Power)
Yes (Surge Protection)
Yes (High Power and Surge Protection)
Potentially (Please explain in "Notes")
(If Applicable) What is your expected power consumption?
1500 - 2000 Watts
2000 - 2500 Watts
Do you require Assistance/Volunteers?
Yes (Set-up assistance)
Possibly (Please Explain in "Notes")
Does your panel involve food/drinks?
If not chosen for Wave 1, would you like to be considered for future waves/back-up panelist?
What, in particular, would make your panel stand out at HRPC?
Notes (Anything else you want us to know!)
Send me a copy of my responses.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service