DFPA Pre-/Post-Show Discussion Information Form

DFPA Pre-/Post-Show Discussion Information Form
Show Title
Date of Pre-/Post-Show Discussion

MonthDayYear
2 digit month, 2 digit day, 4 digit year
Moderator(s)
First and Last Name(s)
Panelist(s)
First and Last Name(s)
Location of Discussion
Supervising Faculty Member
If another faculty member is supervising, please enter their name below.
First and Last Name
Type of Discussion:
Is this Discussion open to the public?
Organization/Group Name (if applicable)
Moderator Name

First NameLast Name
Moderator Email
example@luc.edu
Moderator Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
How long are you anticipating this discussion will go for?
Will the cast be participating in this discussion?
How many chairs will you need?
How many microphones do you need?
Other Information / Notes
Should be Empty: