Breakout Ldr Needs Form Forum Breakouts Thanks for agreeing to do a breakout at Forum on November 20-21 at So Hills Baptist Church. Please fill out this form, and we will get back with you concerning details. Name* First Last Organization*Address*Email* Phone*T-Shirt Size*Spouse name (if attending): First Last Covid Precautions: How concerned are you with spacing within your breakout room?*Not ConcernedSomewhat ConcernedVery ConcernedWill you need a hotel room?*YesNoIf yes, how many nights will you be needing a hotel room?*Title of Your Breakout*Brief description (one - two sentences) of your breakout*Do you have any A/V needs?* Projector Audio Podium Table Extension Cord Projector Screen White Board and Dry Erase Markers CD Player DVD Player Internet Access (if available) Notes or Handouts Other None If other A/V need, please list it here:Do you need your room set up a specific way?*Auditorium StyleSmall GroupsOtherI don't need my room set up a specific wayIf you have notes that you would like us to print, please attach them here.Will you be bringing any promotional materials?*Special requests for snacks & refreshments? (Preferences/dietary restrictions)*Ways our office can pray for you as you prepare?* Forum MenuLocation & Hotels Exhibitors Breakout Ldr Needs Form