Workshop Proposal Form

If you would like to conduct a workshop or show a 3-D video, please fill
out this form.

Title or subject of your workshop or video as you want it to appear in the
printed PROGRAM:

_____________________________________________________________

Description, equipment used, techniques, comments:

_____________________________________________________________

_____________________________________________________________

Equipment you will need NSA to provide: 

_____________________________________________________________

_____________________________________________________________

Equipment you plan to bring: (Make and model of any video projectors)

_____________________________________________________________

_____________________________________________________________

Distance from the screen needed for your projector:

_____________________________________________________________

Size of audience preferred:

_____________________________________________________________

Size of room prefered:

_____________________________________________________________

Will you do your workshop or presentation:

ONE time only _______ or TWO times _______

Indicate days and times you prefer:

Friday Morning: _______ afternoon: _______

Saturday Morning: _______ afternoon: _______

Sunday Morning: _______ afternoon: _______ evening: _______

Your name as you want it printed in the PROGRAM:

_____________________________________________________________

Your mailing address:

_____________________________________________________________

_____________________________________________________________

Your phone at work:

_____________________________________________________________

Your phone at home:

_____________________________________________________________

FAX #:

_____________________________________________________________

E-Mail:

_____________________________________________________________

Please mail this form before June 10, 1999.

Please mail to:

Bill Moll
NSA Workshop Coordinator
224 Glenndale Avenue
Decatur, GA 30030

Tel: (404) 378-3026

E-Mail: WHMoll@aol.com