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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