Programming Application

For programs taking place between Monday, April 15, and Friday, April 19.

Please fill out ALL fields

DEADLINES: 2/28/13 (print advertising), 3/5/13 (web advertising)

  1. Limited Space Available, apply early.
  2. Applications are reviewed weekly. Successful applicants will be contacted within 5 business days of their submission by a member of the Earthstock 2013 Planning Committee.
  3. Please direct questions to Jeff Barnett, Assistant Dean of Students at 631-632-7320, Jeffrey.Barnett@stonybrook.edu.
  4. Exhibitors looking to host a table at the signature festival on the academic mall scheduled for Friday, April 19, 2013 should complete the exhibitor application instead.

Contact Person/Program Coordinator:

Department/Organization:

Contact's Phone Number:

Contact's Email Address:

Title of Program:

Preferred Date and Time of Event:

FIRST Choice Date:

FIRST Choice Time:

SECOND Choice Date:

SECOND Choice Time:


THIRD Choice Date:

THIRD Choice Time:

Number of People Expected to Attend:

Will you be supplying and utilizing A/V?
YES
NO

If yes, what other A/V support can we provide?
TV
DVD/CD player
Laptop
Projector
Microphone
Other  

Please provide detailed information about your event in the boxes below.

I. Program Abstract: Please provide a brief summary of your program and indicate any special features (i.e. performers, food, etc).
Lecture/Workshop
Discussion
Multimedia Presentation
Social Event
Other  

II. Program Goals: Please list your program goals and how they relate to Earthstock.

III. Involvement. Indicate any and all co-sponsoring groups and describe each group’s role in the program.