MVC 2017 Presenter Information Form
Presenter's Name
Your answer
Additional Presenter's Name
Your answer
Additional Presenter's Name
Your answer
Address for Correspondence
Street Address, City/State, Zip Code please
Your answer
Email Address:
Your answer
Phone number
(Area Code) XXX-XXXX
Your answer
Expenses/Honorariums/Travel Reimbursement information.
TRAVEL: Travel reimbursement will be made following submission of a a document showing mileage to and from the conference. It must include a screen capture of the Mapquest or Google Maps routing. This can be emailed to Julie Loucks - jloucks@roe13.org or brought to the conference check in desk.

HOTEL: Hotel accommodations can be made and be a part of the honorarium for those presenters living more than 75 miles from the conference location. Please contact the conference staff for arrangements and eligibility.

Please note, if the honorarium/expenses information is left blank, none will be paid.

Honorarium/Expenses Amount
Your answer
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