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Workshop Planning Form

 Program, Event or Workshop Title: 
 

 Date of event:                                                           Duration:              

 Name of sponsoring organization:

Organization Information

Full mailing address: 

Name and title of primary contact person:

Phone:

Email:

Name and title of backup contact person:

Phone:

Email:

Address of presentation (if different from Organization address)

Name of building:
Which room?

Parking instructions?

Special driving instructions:

Expected number of people in audience:

Equipment checklist:

_____LCD Projector    _____Whiteboard    _____Table    _____Internet connection

Other:
 

Presentation Topic:
Upon completion of the workshop, what change or benefit do you want to have occurred in the participants?