Contact Name *

First Name

Last Name

Phone *

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Panel Format *

Presentation

Q&A

Workshop

Screening + Discussion

Live Demo

Other

Target Audience *

All Ages

Teens (13+)

Adults (18+)

Panel Length Requested *

30 minutes

45 minutes

60 minutes

Flexible

Technical Needs

We will do our best to accommodate and will inform you if there are any issues.

Projector/Screen

Additional Microphone(s)

Internet Access

Tables/Chairs

Other

Would you like to be featured in pre-event promotion? *

Yes

No

Terms & Conditions *

By submitting this application, you agree to abide by all event guidelines, code of conduct, and deadlines. You understand that submission does not guarantee placement and that the FiveStar Comic Con programming team will contact you regarding the status of your application.

I agree to the above terms & conditions

I do not agree to the terms & conditions