BEOS Presenter Form

2015 BEOS speaker information Form

Dear Speaker:

Thank you for your participation in the 2015 Built Environment and Outdoor Summit, October 13–15, 2015, at the Overland Park DoubleTree Hotel, 10100 College Blvd., Overland Park, KS 66210.

Conference website: /

This speaker information form is our main source of information about your presentation, your AV needs, your travel plans and about you. Please make sure all of the information is complete. The edited presentation description, title and your bio will be posted on the conference website and in the printed program.

When you press the Submit button, this form will be sent to John Staples, jstaples@marc.org, (fax: 816.421.7758, attn.: J. Staples). Please call if you have any questions: (d) 816.701.8306 (c) 785.550.5008.

** By submitting this form, you agree that a PDF file of your PowerPoint presentation, or any other documents used in your presentation, may be posted on the conference website, /. Please contact John Staples if you do not wish to have your presentation posted on the website. **

Please make sure that any clip art, cartoons, photos, etc., that you use in your slide presentations, and in any documents used as part of your presentation, are created by you, are in the public domain or that you have written permission to use the image(s).

Thanks again for your participation. We look forward to seeing you at the conference!

Please complete and return this form as soon as possible.

Speaker and presentation information

Name *

First

Last

Email *

Direct phone number *

Cell phone *

Title/Position *

Agency/Organization *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Biographical sketch. Please limit to 75 words. *

Presentation title *

Presentation date & time *

Presentation description. Please limit to 75 words. *

If you have any co-presenters, please list name(s) here. *

If you have a second presentation, please list title here. *

Second presentation date & time. *

Second presentation description. Please limit to 75 words. *

If you have any co-presenters for your second presentation, please list name(s) here. *

If you are speaking at the Funders Roundtable, please include a statement of your organization's funding priorities. Please limit to 75 words. *

presentation logistics and other needs

Each conference room will be equipped with a PowerPoint/LCD projector, a USB slide advancer and screen. We strongly encourage presenters to bring their own laptops and, if needed, any memory devices/thumb drives necessary for the presentation.

If you cannot bring your own laptop, please let us know and we’ll make arrangements to have one available in the room. We are unable to supply Macs; please bring your own, along with an adapter cord for the VGA connection to the projector.

AV Equipment Checklist

Please check the box next to the type of equipment you’ll need us to provide for your presentation. If something is not listed, please describe in the “Other” box.

Choose Any *

Laptop computer. If you check this box, we will provide you with a PC; we don't have access to Macs. Internet connectivity. Flip chart/markers. Other

Other needs. *

If you will have audio or audio/video clips in your presentation, please describe. Include information about the clips – and if they embedded in the presentation, on a separate DVD/CD, etc. *

Handouts

Please bring any supplemental handout materials for your presentations with you to the conference. 35–50 copies should be sufficient.

Your travel and conference schedule. Please check the box next to the date(s) you will attend the conference, including your presentation date. *

Tuesday, October 13 Wednesday, October 14 Thursday, October 15

Travel method (car, plane, bicycle) and details, including arrival and departure dates and times at the DoubleTree Hotel. Please include any other travel information that would be helpful. *

Hotel and reimbursement information

Hotel Reservations

Please make your own hotel reservations at the Hotel. We have a group rate of $94 per night, plus tax. The hotel is the Overland Park DoubleTree Hotel, 10100 College Blvd., Overland Park, KS 66210.

Our hotel reservation cutoff date is September 13, 2015. Please make your room reservation before that date.

You may book a room online at this link, or you may make a room reservation by calling the hotel at 913-451-6100. Our group name is MID AMERICA REGIONAL COUNCIL. Our group code is M9R.

For speakers driving more than 180 miles one way, the conference will cover the cost of the hotel room (room and tax only) at the DoubleTree for the night before or the night of the presentation, whichever is most convenient for the speaker. You may make a reservation for additional nights at your own expense.

Speaker Mileage Reimbursement

Mileage for speakers will be reimbursed at the rate of .575 cents/mile. For speakers driving more than 180 miles one way, the conference will cover the cost of the hotel room (room and tax only) at the DoubleTree for the night before or the night of the presentation, whichever is most convenient for you. You may make a reservation for additional nights at your own expense.

Please remember to submit the attached expense reimbursement form and provide any receipts. Please email form to jmcgraw@kchk.org, and copy to jstaples@marc.org

If you are receiving an honorarium, fee or stipend, please fill in and return the attached W-9 form as well.
Please email form to jmcgraw@kchk.org, and copy to jstaples@marc.org

Submit

kchk-beos_expense_report_2015.xlsx
File Size:	158 kb
File Type:	xlsx

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irs_form_w-9.pdf
File Size:	119 kb
File Type:	pdf

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