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* 1. Event Contact Email Address

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* 2. Event Contact Name

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* 3. Date of Event (if known)

Date / Time

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* 4. If Date is not known, please let us now if you have a general time frame in mind.

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* 5. Location of Event (City, State/Province, Country

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* 6. Name of Event

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* 7. Conference Website (if available)

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* 8. What is the focus/purpose of this event?

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* 9. Event Duration

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* 10. How many attendees are you expecting?

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* 11. What type of attendees do you hope will attend your event?

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* 12. What is the cost per ticket?

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* 13. Will you offer a discount of at least 50% to students?

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* 14. Do you have an anti-harassment policy and if not are you willing to adopt one? (For anti-harassment policies you can review http://geekfeminism.wikia.com/wiki/Conference_anti-harassment/Policy_resources)

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* 15. Are you committed to having a diverse speaker lineup? Please describe what this means to you.

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* 16. In addition to covering business class travel and accommodation expenses, are you offering a speaking fee?

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* 17. What, exactly, are you asking of Andreas? (select all that apply)

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* 18. By what date do you need an answer?

Date / Time

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