Samuraicon 2017 Panel Submission Form
Panel Name *
Name of the event.
Your answer
Panelist Name *
Name of lead panelist of the event.
Your answer
Panelist Email *
Email of lead panelist of the event.
Your answer
Panelist Phone Number *
Phone # of lead panelist of the event.
Your answer
Panel Description *
Describe your panel to us.
Your answer
Program Description *
Panel description for the convention program for attendees.
Your answer
Panel Run Time *
How long will your panel run? Please plan 15 minutes of set up time.
All Ages/18+? *
Intended audience for your panel.
Preferred Time Slot *
Any Tech Needs? *
Do you need a specific tech set up for your panel?
Your answer
Possible Schedule Conflicts?
Your answer
Questions?
Your answer
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