Name of Committee

Chair

Date

I. PROPOSAL

1. Official Title of Program
   
2. Member in Charge:
   Name:
   

   Address:
   

   City/State/Zip:

   Telephone:
   

   e-mail:
   

3. If member in charge cannot be contacted, who should/can answer questions on this request?

   Name
   

   Address
   

   City/State/Zip
   

   Telephone
   

   e-mail
   

4. Conference Site:
   
5. Requested dates and times:

6.  Estimated Attendance: (As this information impacts room assignments, please consider carefully the potential audience size.)

1. Co-Sponsors:
   

   Co-Sponsor Responsibilities:
   

2. Type of Program
   Annual Conference
   Pre-Conference
   Other (Please explain below)
   
3. Audiotaping the Program (I understand that ALA Conference Services makes the final decision about taping.)
   Yes  No

II. Program Outline

1. Detailed Agenda - Describe the program format, speakers, titles of speeches and approximate times.
   
2. Follow-through Plans (i.e. YALS article, booklists, etc.)
   

III. Program Costs

To reduce the cost of programs, all AV requests must be made in writing to the YALSA office by February 1 preceeding the Annual Conference where the program takes place. Any expenses, besides copies of handouts, must be cleared by the YALSA office.

IV. Confirmation of Program Plans For:

1. Official Title of Program:
   
2. Speaker Name
   

   Confirmed: Yes  No

   Address
   

   City/State/Zip
   

   Telephone
   

   e-mail
   

3. Speaker Name
   

   Confirmed: Yes  No

   Address
   

   City/State/Zip
   

   Telephone
   

   e-mail
   

4. Speaker Name
   

   Confirmed: Yes  No

   Address
   

   City/State/Zip
   

   Telephone
   

   e-mail
   

5. Speaker Name
   

   Confirmed: Yes  No

   Address
   

   City/State/Zip
   

   Telephone
   

   e-mail
   

Please Note: Letters of Agreement will be sent by the YALSA Office approximagely three months before the program. The office MUST have correct name and contact information for ALL speakers by that time.

Slot assigned by ALA Conference Planning Office
Date

Time