* 2. First Name

* 3. Last Name

* 4. E-mail address

* 5. Country of Residence in May 2017

* 10. Paper (Individual or Part of Panel), Film or Book Title

* 11. Panel Title (if submitting as a part of a Panel Proposal)

* 15. Will you require Audio-Visual for your presentation?
(Please note that in order to use a projector, you must bring your own laptop)

* 18. Affiliation (University/Organization/Independent Researcher)

* 19. If your application is accepted, will you require a printed invitation (for visa/reimbursement)?

* 20. Do you require a visa?

* 21. If yes, please provide us with your preferred Postal Address (please include: street, city, country, postal/zip code)

* 22. If you are a PhD student, please indicate the provisional title of your dissertation (in the language in which it is to be written) and expected year of defense (a month is necessary for a 2016 defense).

* 23. Attendance (Have you attended the Convention before?)

* 24. If yes, what year was the last time (1999-2016)?

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