RWA2019 Speaker Information and Release Form Survey

Speaker Information

Type your name as you would like it to appear on all conference-related materials.

First Name(Required.)

Last Name
(Required.)

E-mail Address for Workshop Updates

Cell Phone Number (for contact onsite at the RWA Conference, if needed)

Please list any speaker ADA Accommodations (i.e. no riser at head table)

Participation Agreement(Required.)

I agree to participate in the 2019 RWA Annual Conference as a workshop speaker. I certify that my session is my original material and/or that I have written permission from the copyright holder to reproduce his/her copyrighted work. This session does not infringe on anyone else's copyrights and is not defamatory.

Speaker Biography

Please e-mail a copy of your bio and headshot to workshops@rwa.org no later than February 15, 2019.

I do hereby affirm that the statements provided in my bio are true and accurate.(Required.)

Agree

Session Information

The Title/Topic of My Session is:

Preferred Session Moderator:

Equipment Request (Other than standard wired microphones): {Select all that apply}

LCD projector and screen (presenters must provide their own laptops)

Audio patch from computer to speakers

Aisle microphone

Wireless microphones

Lapel microphones

Other Special Equipment Request:

Room Set Request: {Select all that apply}

Room Set Special Request (set not listed above):

Conference Handout Release

RWA encourages participants to provide conference handouts. Please e-mail your handouts to workshops@rwa.org by April 2, 2019. Handouts will be provided for download by conference registrants. Paper copies will not be provided onsite.

I will have conference handouts. I understand and agree to this release: I agree to grant RWA the right to include copies of my handout materials for download to conference attendees. I also grant the right for my handouts to be included with sales of recordings of my session (if recorded). I understand that I retain all rights to the use, publication, and reproduction of this material. I further certify that all handout material is my original work and/or that I have written permission from the copyright holder to reproduce his/her copyrighted work. This work does not infringe on anyone else's copyrights and is not defamatory, and I have the full right to make this license. I agree to hold the association harmless from any lawsuits resulting from the inaccuracy or breach of these assurnaces.

Yes

Workshop Audio Release

As part of our continuing efforts to educate our members, RWA has arranged for conference workshops to be recorded on Flash Drives and as downloable files. Flash Drives and downloads will be available for purchase by conference attendees, and then to RWA members and non-members through the RWA site. They are protected by copyright from any unauthorized use and/or duplication. The partial conference speaker discount/waiver constitutes payment to the speaker. RWA requests your permission to have your workshop recorded. In presentations with more than one speaker, all participants must agree to be recorded.

RWA requests your permission to have your workshop recorded. In presentations with more than one speaker, all participants must agree to be recorded.

I hereby consent to the recording and duplication of my 2019 RWA Annual Conference workshop. I understand that by agreeing to the recording of my session, I am granting RWA the non-exclusive right to audiotape my presentation and use and/or sell the recording in any manner on a royalty-free basis following the presentation. I also understand that agreeing to the recording does not prohibit me from using my material in any way I choose at any future time.

I do not want to be recorded.

I agree to a transcription of my audio recording being provided to individuals who request it as an ADA accommodation.

Yes

Speaker Fee Discount/Waiver
Speakers must register to attend the conference. Speakers who fail to register by the conference registration deadline will be replaced.

For RWA2019, each author/member speaker will receive a $120 speaker waiver/discount from the conference registration fee. No individual member speaker may receive more than the $120 for the year.

I understand that as a workshop speaker, the compensation that I am entitled to receive is a discount on my conference fee. I understand that I must complete a conference registration form and apply the discount code at the time of registration.

I agree to the statement above.

Individuals wishing to donate their discount to RWA's Perseverance Fund should not use the discount code and notify workshops@rwa.org.

RWA Book Fair (Note: This is not the literacy autographing. This is an onsite bookstore.)
The book fair vendor will make every ordinary effort to obtain sufficient copies of recommended titles. However, the vendor cannot guarantee the title will be available for sale at the book fair.

Note: For special order titles, the author may need to make special arrangements with the onsite bookseller. Please contact workshops@rwa.org with questions.

Research Titles

Book Title 1

ISBN 1

Author 1

Publication Date 1

Publisher 1

Book Title 2

ISBN 2

Author 2

Publication Date 2

Publisher 2

Speaker/Author Titles

Book Title 3

ISBN 3

Author 3

Publication Date 3

Publisher 3

Book Title 4

ISBN 4

Author 4

Publication Date 4

Publisher 4