Workshop Submission Form

Name*

First Last

Display Name

How would you like to be listed publicly if different from above?

Can you attend both days of GeekGirlCon 2019?*

Yes, I can attend both Saturday 11/16/19 and Sunday 11/17/19
No, I can only attend Saturday 11/16/19
No, I can only attend Sunday 11/17/19

Email*

Phone*

This information will be used ONLY in emergencies for day-of contact.

Short Bio*

Please write in the third person and keep under ~60 words

Website

Twitter Handle

Are you willing to be interviewed by a member of the press?*

Yes, I am willing
No, I'd rather not

Are you also submitting a panel or other application to GeekGirlCon 2019 or do you anticipate being on a GeekGirlCon 2019 panel?*

Yes
No
Not sure yet

Any additional information about yourself that you would like to add?

Workshop Title*

This title will appear on our website and in our program guide, so please choose your words accordingly.

Please give a concise but specific description of your workshop.*

Please keep under ~200 words

How is your workshop on-mission?*

What format will your presentation be?*

Some non-exhaustive options include: discussion-based, presentation-based, crafting-based, a mix, etc.

We want workshops at GeekGirlCon to be as interactive and hands-on as possible. Give a detailed description of the hands-on component of your workshop and of how you will engage and interact with your workshop participants.*

Will your workshop participants receive anything to bring home and/or continue their learning outside of the workshop (a hand-out, a finished craft, a preliminary game board, a resource list, etc)?*

Can you include any examples of presentation materials now (hand-outs, outlines, etc)? If so, please attach them below.*

Yes
No
Not yet

Please upload any presentation materials here.

Drop files here or

How many participants can your workshop support?*

Please note that our limit, due to space restrictions, is 55 participants.

What age groups is your workshop appropriate for?*

Please select all options that apply.

0-4
4-8
8-12
12+
Only 18+

How long is your workshop/can your workshop be?*

Please select one or both options.

60 minutes
90 minutes

Describe your A/V or equipment needs, if any.*

Please note that workshop rooms are equipped with projector screens and microphones. YOU MUST BRING YOUR OWN DONGLE to hook up to the HDMI cord attached to the projector.

Provide an estimate of the cost of workshop materials.*

Note that workshop facilitators are responsible for the initial purchase of materials and for the transportation of materials to the con and must submit an itemized invoice with receipts for reimbursement.

Are you willing to make changes to this workshop?*

Sometimes we request changes be made in order for workshops to be presented at GeekGirlCon. Changes might include altering the title, shortening the time, or shifting the focus slightly.

Yes, absolutely
No, I'd rather not
Maybe

How many co-facilitators, helpers, or assistants do you have?*

Please note that you may have as many or as few co-facilitators as you'd like, but we need to know who will be assisting you in order to grant them con passes.

Are you or your workshop co-facilitators members of under-represented communities? If so, which communities?

Demographics questionnaire

The questions below do not increase or decrease the likelihood of your participation.

How did you hear about GeekGirlCon?*

I identify my ethnicity as:

Asian
Black/African
Caucasian
Hispanic/Latinx
Native American
Middle Eastern
Pacific Islander
Other

My gender is:

Female
Male
Non-binary
Other

Do you identify as transgender?

Yes
No

Contributor #1

Name*

First Last

Display Name

How would you like to be listed publicly if different from above?

Can this contributor attend both days of GeekGirlCon?*

Yes, they can attend both Saturday and Sunday
No, they can only attend Saturday
No, they can only attend Sunday

Email*

Enter Email Confirm Email

Phone*

This information will be used ONLY in emergencies for day-of contact.

Short Bio*

Please write in the third person and keep under ~60 words

Website

Twitter Handle

Is this contributor willing to be interviewed by a member of the press?*

Yes, they are willing
No, they would rather not

Is this contributor also submitting a panel or other application to GeekGirlCon or do they anticipate being on a GeekGirlCon panel?*

Yes
No
Not sure yet

Contributor #2

Name*

First Last

Display Name

How would this contributor like to be listed publicly if different from above?

Can this contributor attend both days of GeekGirlCon?*

Yes, they can attend both Saturday and Sunday
No, they can only attend Saturday
No, they can only attend Sunday

Email*

Enter Email Confirm Email

Phone*

This information will be used ONLY in emergencies for day-of contact.

Short Bio*

Please write in the third person and keep under ~60 words

Website

Twitter Handle

Is this contributor willing to be interviewed by a member of the press?*

Yes, they are willing
No, they would rather not

Is this contributor also submitting a panel or other application to GeekGirlCon or do they anticipate being on a GeekGirlCon panel?*

Yes
No
Not sure yet

Contributor #3

Name*

First Last

Display Name

How would this contributor like to be listed publicly if different from above?

Can this contributor attend both days of GeekGirlCon?*

Yes, they can attend both Saturday and Sunday
No, they can only attend Saturday
No, they can only attend Sunday

Email*

Enter Email Confirm Email

Phone*

This information will be used ONLY in emergencies for day-of contact.

Short Bio*

Please write in the third person and keep under ~60 words

Website

Twitter Handle

Is this contributor willing to be interviewed by a member of the press?*

Yes, they are willing
No, they would rather not

Is this contributor also submitting a panel or other application to GeekGirlCon or do they anticipate being on a GeekGirlCon panel?*

Yes
No
Not sure yet

Contributor #4

Name*

First Last

Display Name

How would this contributor like to be listed publicly if different from above?

Can this contributor attend both days of GeekGirlCon?*

Yes, they can attend both Saturday and Sunday
No, they can only attend Saturday
No, they can only attend Sunday

Email*

Enter Email Confirm Email

Phone*

This information will be used ONLY in emergencies for day-of contact.

Short Bio*

Please write in the third person and keep under ~60 words

Website

Twitter Handle

Is this contributor willing to be interviewed by a member of the press?*

Yes, they are willing
No, they would rather not

Is this contributor also submitting a panel or other application to GeekGirlCon or do they anticipate being on a GeekGirlCon panel?*

Yes
No
Not sure yet

Contributor #5

Name*

First Last

Display Name

How would this contributor like to be listed publicly if different from above?

Can this contributor attend both days of GeekGirlCon?*

Yes, they can attend both Saturday and Sunday
No, they can only attend Saturday
No, they can only attend Sunday

Email*

Enter Email Confirm Email

Phone*

This information will be used ONLY in emergencies for day-of contact.

Short Bio*

Please write in the third person and keep under ~60 words

Website

Twitter Handle

Is this contributor willing to be interviewed by a member of the press?*

Yes, they are willing
No, they would rather not

Is this contributor also submitting a panel or other application to GeekGirlCon or do they anticipate being on a GeekGirlCon panel?*

Yes
No
Not sure yet

Programming Submissions