Program Proposal Form
Page 1 of 8 / FOR LLAMA USE
EVENT / LOCATION / PROPOSAL FORM DUE
2012 Annual Conference - Program / June 21-26, Anaheim, CA / Annual Conference, 2011
2012 Annual Conference - Preconference / June 21-26, Anaheim, CA / Annual Conference, 2011
2013 Midwinter Meeting - Midwinter Institute
(Full day, in person) / January 25-29, Seattle, WA / Annual Conference, 2012
2013 Annual Conference –
Program / June 27-July 2, Chicago, IL / Annual Conference, 2012
2013 Annual Conference -
Preconference
(Full day, in person) / June 27-July 2, Chicago, IL / Annual Conference, 2012
2014 Midwinter Meeting
Midwinter Institute
(Full day, in person) / January 24-28, Philadelphia, PA / Annual Conference 2013
LLAMA Webinar –
(60-90 min.) / Online throughout the year / At least 8 weeks before webinar
Section I: BASIC PROGRAM INFORMATION
Contact Information
Program Chair Name:
Address:
City:
State: Zip:
E-Mail:
Daytime Phone: Fax:
LLAMA Sponsors and Approvals Have the appropriate committee and section chairs approved this program? Yes: No
Section:
Committee:
Discussion Group:
Title/75-Word Description
Please provide a title and a descriptionof the proposed sessionno longer than 75 words. Creative, interesting and informative titles and descriptions are best. Do not include presenter names, abbreviations, or acronyms. If the program is accepted, this description will be used in all promotional materials and may be edited for style and clarity by ALA staff.
Title:
Description (75 words maximum):
Purpose and objectives
Why is this program important and timely?:
Has this program been presented previously? YesNo If yes, where and when?:
Please identify three (3) objectives for your session.
(Objectives should use active verbs, be concrete, and state what the program participants should know or be able to do; they should not simply repeat topics that will be addressed. Objectives should be achievable and realistic given the length and scope of the proposed program)
Objective 1. At the end of this program, participants will:
Objective 2. At the end of this program, participants will:
Objective 3. At the end of this program, participants will:
How have diversity-related issues associated with this subject been incorporated into the program?
Target Audience
For whom is this program primarily intended?
Estimated Audience Size
50-100101-150 151-200 201-300 301-400 Other
Program Day and Time
Check One / Check OneSaturday
Sunday
Monday
Tuesday
Monday 10:30-12:00 p.m. is the “no conflict” time / 8:00 a.m. – 10:00 a.m.
8:00 a.m. – 12:00 p.m.
10:30 a.m. – 12:00 p.m.
1:30 p.m. – 3:30 p.m.
1:30 p.m. – 5:30 p.m.
4:00 p.m. – 5:30 p.m.
Day and time Restrictions (i.e., speaker date restrictions, conflict times, etc.):
Alternate Day and Time if first choice is not available:
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Required Attachments Completed
Section I: Basic Program Information
Section II: Program Outline
Section III: Speaker Information
Section VI: Budget
SectionV: Program Format, Room Configuration, and Technology Needs
Section VI:Co-Sponsorships and Endorsements
Section VII: Publicity
A note on Signatures and Approvals
Approvals by the sponsoring committee and section chair are required.In this current version of the electronic program proposal form there is no provision for electronic signatures. There is a check box on the first page of the form (above) to indicate that the appropriate approvals have been obtained. It is the responsibility of the program chair to secure the approvals before submitting the proposal. Include here complete section chair and sponsoring committee contact information.
Sponsoring Section and Committee______
Section Chair Contact Information(name, address, phone, email) ______
Sponsoring Committee Chair Contact Information (name, address, phone, email)
______
Program approved Yes No Amount approved $ DateProgram referred back to Chair
SectionII: PROGRAM OUTLINE (Fill in as appropriate)
Welcome:
Introductions:
Moderator Name:
Speaker #1Name:
Time allotted:
Title:
Short description:
Speaker #2Name:
Time allotted:
Title:
Short description:
Speaker #3Name:
Time allotted:
Title:
Short description:
Speaker #4Name:
Time allotted:
Title:
Short description:
Break-out Sessions
Total Time allotted
Session #1
Time allotted
Session #2
Time allotted
Session #3
Time allotted
Discussion/Questions and Answers
Time allotted:
Wrap-up
Speaker name:
Time allotted:
SectionIII: SPEAKER INFORMATION
Please fill in the speaker information on the forms below. Include as much information as you currently have available.
Have speakers from diverse ethnic backgrounds been considered as presenters? Yes No
SPEAKER #1TITLE
ADDRESS
E-MAIL / PHONE / FAX
ALA MEMBER? / yes no / Topic:
LLAMA MEMBER? / yes no
SPEAKER #2
TITLE
ADDRESS
E-MAIL / PHONE / FAX
ALA MEMBER? / yes no / Topic:
LLAMA MEMBER? / yes no
SPEAKER #3
TITLE
ADDRESS
E-MAIL / PHONE / FAX
ALA MEMBER? / yes no / Topic:
LLAMA MEMBER? / yes no
SPEAKER #4
TITLE
ADDRESS
E-MAIL / PHONE / FAX
ALA MEMBER? / yes no / Topic:
LLAMA MEMBER? / yes no
If there are more speakers, please use an additional speaker forms.
Section IV: BUDGET
Estimated costs are acceptable for this form. Final budgets are due November 1 prior to the Midwinter Meeting of the Program Committee. The Program Committee reviews program budgets and recommends final approval to the LLAMA Board at the Midwinter Meeting prior to the program presentation.
Please note the following:
-ALA practice precludes payment of honoraria or expenses for ALA members.
-Equipment needs must be approved by the Program Committee, but equipment rental
charges are paid by ALA. The deadline for requesting equipment is March 1 prior to Annual Conference.
-LLAMA does not provide funds for publicity.
Speaker expenses (see LLAMA Policy on Honoraria & Reimbursement):
Speaker #1 Name: Travel Costs $
Honorarium $
Per Diem?:yes no
Speaker #2 Name: Travel Costs $
Honorarium $
Per Diem?:yes no
Speaker #3 Name: Travel Costs $
Honorarium $
Per Diem?:yes no
Speaker #4 Name: Travel Costs $
Honorarium $
Per Diem?:yes no
TOTAL SPEAKER COSTS $______
Handouts for Distribution at the Program:
X X $ .05 = $
(# of copies) (# of pages) (per side) (Total cost for handouts)
Other expenses (Itemize and List):
$
$
$
TOTAL PROGRAM EXPENSES $ ______
Funding from Non-LLAMA sources (Itemize and List):
$
$
$
TOTAL BUDGET REQUEST $ ______
(Total program expenses minus non-LLAMA funding)
Section V: PROGRAM FORMAT, ROOM CONFIGURATION, A/V AND COMPUTER REQUIREMENTS
Program Format
Please check the formats that will provide the best educational experience for participants. If more than one format is identified, please explain below.
Live presentation small group discussions
Webinar panel presentation
Single speaker hands-on exercises
Single speaker with reactor panel debate
Other/Please explain:
Room Set-Up
Standard room set-up includes a podium. Please use the options below to identify and explain any unique need proposed program.
Theater-style (rows of chairs)
Schoolroom (rows of chairs and tables)
Rounds (tables of 8 or 10 for small group discussion)
Breakout rooms (quantity including main room:)
Will the program require a head table in addition to a podium?
Yes no (If yes, for how many people?
Other requests:
Specific requirements for people with disabilities:
Technology: Presentation Support and Other Equipment
Please identify the equipment from the list below that will be required by the presenters at the proposed session identify a need for equipment unless it is absolutely necessary to avoid unnecessary costs. Equipment rental charges are funded by ALA General Funds. The deadline for equipment requests is February 1 prior to the Annual Conference.
Computer projection equipment (LCD and screen)
Pointers (electric wood )
Flip charts, paper/markers (quantity:
Microphones
Floor (quantity) table (quantity) lavaliere (quantity)
Laptop computer and projector*
With live internet connection and software
With PowerPoint software
With Windows software (most current version)
Overhead projector (for transparencies) and screen
DVD/ VCR and Monitor
Phone/data line
Other (describe):
*Presenters who wish to bring their own laptop computers should discuss this request with LLAMA office staff.
Section VI: CO-SPONSORSHIPS and ENDORSEMENTS
Co-sponsorship of LLAMA programs is permitted only when it involves substantive participation by the co-sponsoring unit in the planning and/or presentation of the program. Co-sponsorship must be sought at the beginning of the program development process. Co-sponsorship should be considered when the participation of another group can enlarge the scope of a topic, bring additional expertise to the program, or increase the potential audience.
Discussion group programs are required by ALA to have co-sponsorship by LLAMA or one of its sections or committees or by another membership unit of ALA.
Yes, I plan to seek co-sponsorship of this program with the following ALA/LLAMA group(s):
Nature of Co-sponsorship
Check here if the co-sponsorship will be in name only:
Check here if the co-sponsorship will include shared financial responsibility:
Please describe further the nature of the co-sponsorship:
Endorsement of a program may be sought from non-participating units to increase publicity and attendance for the program.
Yes, I plan to seek endorsement of this program with the following ALA/LLAMA group(s):
Sponsoring Group
LLAMA programs at ALA Annual Conference must be sponsored by a committee of LLAMA (LLAMA discussion groups may submit programs but must seek the sponsorship of a LLAMA committee).
Sponsoring LLAMA Section:
Sponsoring LLAMA Committee:
This program originated in the following LLAMA discussion group:
Co-sponsoring/Endorsing Group
Group Name:
Chair of Group:
Address:
Phone: Email:
Check here to show that the approval of the co-sponsoring/ endorsing group chair has been secured:
Section VII: PUBLICITY
If you plan to present your program content in other ways, please list and explain:
Please list ways in which you plan to promote attendance at your program:
1.
2.
3.
Other.
E-mail this form to:
with “Program Proposal Form” in the subject field.