Presenter Questionnaire

In order to ensure that your needs are met during your time with us, please complete the following information. We will make every effort to accommodate your needs. We appreciate your commitment to this cause. Please submit this form no later than September 15th.

About You

If you have not submitted a biographical sketch and/or photo, Rev. Dwylene Butler has searched the internet to find one for you. If what we have on the website is not acceptable to you, please submit the information you want to be used here or email to dbutler@smzbc.org.

About Your Session

We have assigned you topic names and very general descriptions. If you would like more information to be provided for attendees and to be printed in the program, please submit the information you want to be used here.

Breakout Session Title *

Breakout Session Synopsis *

What supplies will you need for your session? *

LCD Projector & Screen DVD/Blu-Ray Player & TV Device to Play Music (CD/MP3) Dry Erase Board, Marker, Eraser Flip Chart, Marker, Easel Materials to Be Printed in Program (I will submit by September 15th) I Do Not Need You to Provide Any Supplies

Would you like Vendor Space to sell your books, DVDs, or other materials throughout the weekend? *

Yes No

IMPORTANT NOTES: Rather than give out handouts in individual sessions, our conference program book will have all printed materials from presenters. This allows those who may not take your session to have access to the information shared. // Also, if you are using a PowerPoint or Keynote presentation in your session, we prefer to get those in advance to be sure they work on our devices. // Our Chruch building is very old, and the internet is unreliable here. If there is a web-based video or site you want to access during your session PLEASE let us know by September 15th, we can often download the information before hand. // If you plan to distribute any written documents or use a PowerPoint or Keynote, please upload them here or email to dbutler@smzbc.org.

Your Preferences

Before presenting, I would like: *

Saturday Afternoon Lunch *

While presenting, I would like: *

After presenting, I would like: *

Please specify any food allergies you may have here: *

We understand that some service providers are unable to accept "gifts of appreciation" in return for their participation in certain events. Are you able to accept gifts of appreciation for your presentation? *

No, I am unable to receive any gifts or services for my presentation. Yes, I am able to receive a gift of appreciation for my presentation.

Holistic Hurt, Wholistic Healing Presenter Questionnaire

About You

About Your Session

Your Preferences