1. *Name:
2. *Phone:
3. *Email Address:
4. *Confirm Email Address:

1. *Panel Title:

   30 character limit! Keep it short and sweet.

2. *What kind of panel is this?
   This is an industry panel This is a general panel or fan panel This is a steampunk panel at the Clockwork Alchemy venue

   Industry Panel Submissions:
   To have a panel accepted as an 'Industry' panel, your panel must be hosted by a company who has contacted FanimeCon's marketing department about attending our convention as 'Industry'.
   Please submit only one 'Industry' panel per company.
   Additional panels hosted by that company should be submitted as separate general panels.

3. *Panel Category: Cosplay Dojo Entertainment/Show Game/Contest Gathering/Debate How To/Demo Industry/Promotional Informational/Presentation Manga/Webcomics Music Working in the Industry Steampunk-Culture Steampunk-Fashion Steampunk-History Steampunk-Literature Steampunk-Technology Steampunk-Theater Steampunk-Workshop Steampunk-Solo Presentation

   For grouping purposes, please select the category that best fits your panel.
   Clockwork Alchemy panelists should select one of the steampunk categories.

4. Company Name:

   This is required for Industry panels.

5. Panel Helper:

   "For Fan Panels ONLY, if you have someone helping to give the panel and would like to get them a discount on their Fanime badge, please list their full real name here.
   Limit, 1 helper discount per panel.

1. *Panel Description:

   This is the text that will go on the website and in the program guide.
   Descriptions must be 300 characters or less, including whitespace.

2. *Panel Overview:

   Explain to FanimeCon staff what you want to do and how you want to do it.
   What topics, presentations, or discussions are you planning?

3. *Photo/Video Restrictions: No restrictions on video recording or photography Photography OK, but no video recording No video recording or photography allowed

   For Industry Panels we will do our best to honor any restrictions.
   Generally, Fan Panels are given without any restrictions on photo/video

4. *Expected Audience Size: 10-20 20-50 50-100 100-200 200-300 300+
5. *Age Restrictions: Suitable for All Ages 16+ (not recommended for those under 16) 18+ (audience must be 18 or over, ID will be checked)
6. *Have you given this panel before? When and where? What was the estimated attendance?
7. Other Notes or Comments or Questions:

1. Equipment Needed:
   Microphones DVD Player Display/Projector with VGA cable Display/Projector with S-Video cable Display/Projector with DVI cable I need to connect ___ to ____

   If the last box is checked, please give us a brief explanation of your needs so we may best assist you.

2. Laptop:

   If you need to connect a laptop to a display/projector, please indicate the brand and model of laptop. For instance, "Thinkpad T45"
   Also, please bring your own VGA connectors, if possible.

3. Other Equipment Needs:

1. *Panel Length: 1 hour 2 hours

   Please note that we do not schedule panels over an hour in length between noon and 5pm on Saturday or Sunday.

2. *First Choice: Friday Early Afternoon (starts at 2pm or 3pm) Friday Late Afternoon (starts at 4pm or 5pm or 6pm) Friday Evening (starts at 7pm or 8pm or 9pm) Friday Night (starts at 10pm or 11pm or 12mid or 1am) Saturday Morning (starts at 10am or 11am) Saturday Early Afternoon (starts at 12noon or 1pm or 2pm or 3pm) Saturday Late Afternoon (starts at 4pm or 5pm or 6pm) Saturday Evening (starts at 7pm or 8pm or 9pm) Saturday Night (starts at 10pm or 11pm or 12mid or 1am) Sunday Morning (starts at 10am or 11am) Sunday Early Afternoon (starts at 12noon or 1pm or 2pm or 3pm) Sunday Late Afternoon (starts at 4pm or 5pm or 6pm) Sunday Evening (starts at 7pm or 8pm or 9pm) Sunday Night (starts at 10pm or 11pm or 12mid or 1am) Monday Morning (starts at 10am or 11am) Monday Early Afternoon (starts at 12noon or 1pm or 2pm)

   Please choose a preferred starting time for your panel from the available time blocks.

3. *Second Choice: Friday Early Afternoon (starts at 2pm or 3pm) Friday Late Afternoon (starts at 4pm or 5pm or 6pm) Friday Evening (starts at 7pm or 8pm or 9pm) Friday Night (starts at 10pm or 11pm or 12mid or 1am) Saturday Morning (starts at 10am or 11am) Saturday Late Afternoon (starts at 5pm or 6pm) Saturday Evening (starts at 7pm or 8pm or 9pm) Saturday Night (starts at 10pm or 11pm or 12mid or 1am) Sunday Morning (starts at 10am or 11am) Sunday Late Afternoon (starts at 5pm or 6pm) Sunday Evening (starts at 7pm or 8pm or 9pm) Sunday Night (starts at 10pm or 11pm or 12mid or 1am) Monday Morning (starts at 10am or 11am) Monday Early Afternoon (starts at 12noon or 1pm or 2pm)

   Your second and third choices must be outside of Saturday/Sunday noon-4pm. Generally these periods fill up quickly.

4. *Third Choice: Friday Early Afternoon (starts at 2pm or 3pm) Friday Late Afternoon (starts at 4pm or 5pm or 6pm) Friday Evening (starts at 7pm or 8pm or 9pm) Friday Night (starts at 10pm or 11pm or 12mid or 1am) Saturday Morning (starts at 10am or 11am) Saturday Late Afternoon (starts at 5pm or 6pm) Saturday Evening (starts at 7pm or 8pm or 9pm) Saturday Night (starts at 10pm or 11pm or 12mid or 1am) Sunday Morning (starts at 10am or 11am) Sunday Late Afternoon (starts at 5pm or 6pm) Sunday Evening (starts at 7pm or 8pm or 9pm) Sunday Night (starts at 10pm or 11pm or 12mid or 1am) Monday Morning (starts at 10am or 11am) Monday Early Afternoon (starts at 12noon or 1pm or 2pm)

   Also, please note that Steampunk / Clockwork Alchemy panels are only scheduled in the Morning, Early Afternoon, and Late Afternoon slots.
   There are no Early Evening or Late Evening slots available for Clockwork Alchemy.

5. *If we cannot schedule your panel from your first three choices, can you list any times and dates that you will NOT be available?

While FanimeCon will try to accommodate all panel requests, this form does not guarantee availablity or starting times.

This form will send the information to our panel coordinators.

They will contact you to confirm the panel, and make changes as needed.

Thank you very much for your interest in FanimeCon 2012 and we hope to see you soon!