August 25-26, 2018

Name

Email Address

Phone Number

Panel Name

Panel Description

What day(s) are you available for the panel? Check all that apply. * What day(s) are you available for the panel? Check all that apply. * Saturday Aug 25th Sunday Aug 26th

What time(s) are you available for the panel? Check all that apply. * What time(s) are you available for the panel? Check all that apply. * Morning 10AM - 2PM Evening 2PM - 6PM

What age range is your panel for? * What age range is your panel for? * Kids All Ages Ages 13+ Ages 18+

How many panelists, including yourself, would be part of your panel? * How many panelists, including yourself, would be part of your panel? * 1 2 3

How long would your panel be? * How long would your panel be? * 30 Minutes 60 Minutes 90 Minutes 120 Minutes Other

Please elaborate on the time required for your panel?

Are you interested in repeating this panel during your other available day(s)? * Are you interested in repeating this panel during your other available day(s)? * Yes No

Alternate title for the repeated panel, if desired.

How did you hear about the opportunity to panel at our convention? How did you hear about the opportunity to panel at our convention?Convention Web SiteConvention FacebookWord of MouthComicbook StoreOther

Please elaborate on the ComicBook Store or Other Source

Number