MILCOM 2017 Technical Panel Proposal

Please fill out this form with as much information as you can.

Note: Questions highlighted with an asterisks are required.

Question Title

* 1. What is the suggested panel title?

Question Title

* 2. Subject keywords

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* 3. Panel description/abstract:

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* 4. Proposed duration (60 - 120 minutes suggested):

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* 5. Panel Organizer:

First Name:

Last Name:

Title:

Organization:

Email:

Phone (Office):

Phone (Mobile):

Question Title

* 6. Panel Moderator:

First Name:

Last Name:

Title:

Organization:

E-mail:

Phone (Office):

Phone (Mobile):

Status ("Proposed", "Invited", "Confirmed"):

Position Statement (25 words or less):

Bio (100 words or less)

Question Title

* 7. Panelist 1:

First Name:

Last Name:

Title:

Organization:

E-mail:

Phone (Office):

Phone (Mobile):

Status ("Proposed", "Invited", "Confirmed"):

Position Statement (25 words or less):

Bio (100 words or less):

Question Title

* 8. Panelist 2:

First Name:

Last Name:

Title:

Organization:

E-mail:

Phone (Office):

Phone (Mobile):

Status ("Proposed", "Invited", "Confirmed"):

Position Statement (25 words or less):

Bio (100 words or less):

Question Title

* 9. Panelist 3:

First Name:

Last Name:

Title:

Organization:

E-mail:

Phone (Office):

Phone (Mobile):

Status ("Proposed", "Invited", "Confirmed"):

Position Statement (25 words or less):

Bio (100 words or less):

Question Title

* 10. Panelist 4:

First Name:

Last Name:

Title:

Organization:

E-mail:

Phone (Office):

Phone (Mobile):

Status ("Proposed", "Invited", "Confirmed"):

Position Statement (25 words or less):

Bio (100 words or less):

Question Title

* 11. Panelist 5:

First Name:

Last Name:

Title:

Organization:

E-mail:

Phone (Office):

Phone (Mobile):

Status ("Proposed", "Invited", "Confirmed"):

Position Statement (25 words or less):

Bio (100 words or less):

Question Title

* 1. What is the suggested panel title?

Question Title

* 2. Subject keywords

Question Title

* 3. Panel description/abstract:

Question Title

* 4. Proposed duration (60 - 120 minutes suggested):

Question Title

* 5. Panel Organizer:

Question Title

* 6. Panel Moderator:

Question Title

* 7. Panelist 1:

Question Title

* 8. Panelist 2:

Question Title

* 9. Panelist 3:

Question Title

* 10. Panelist 4:

Question Title

* 11. Panelist 5:

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* 12. Additional information: