eLabs Conference Presenter Form Preferred Name(Required)Please provide your name as you would like it to appear on your conference badge.Email address(Required) PronounsPlease provide your pronouns as you would like them to appear on your conference badge.Institutional or Project AffiliationIf you have an institutional or project affiliation you would like to include on your conference badge, please provide those details here. If there are multiple affiliations, provide the one you will be representing for this conference.Would you like for your name, email, or affiliation (if provided) to appear in the conference directory of attendees?(Required) Yes No Professional HeadshotWe intend to create a graphic for each conference session, to be used, for example when commencing a new conference session on Zoom or for teasing upcoming sessions on social media. These graphics will introduce the session name and list the contributing panelists. If you would prefer for your image not to be included in such a graphic, please leave this field blank.Accepted file types: jpg, jpeg, png, gif.Presentation LogisticsPresentation Title(Required)Dates of Attendance(Required)Please select all dates you would like to attend. To learn more about the pre-conference workshops scheduled for August 7, please see our conference events. Pre-Conference Workshop: Practical Strategies for Web Accessible and Environmentally Sustainable Digital Projects (Aug. 7, 9:30 AM–4:30 PM) Pre-Conference Workshop: Strategies for Finding Scattered Documents (Aug. 7, 1:00–4:30 PM) Conference Day 1 (Saturday, August 8 | 9:00 AM–5:00 PM) Conference Day 2 (Sunday, August 9 | 9:00 AM–4:00 PM) Select AllAudiovisual or Technology NeedsA projector, projection screen, and laptop will be provided by the venue. If any additional technology is needed for your presentation, please specify here.Travel LogisticsIn order to cover the cost of your travel and lodging, we will book directly on your behalf. Please complete the following information, so that we may book your preferred travel itinerary.Preferred Date of Arrival(Required)Please enter your preferred date of arrival, using the MM/DD/YYYY format.Preferred Date of Departure(Required)Please enter your preferred date of departure, using the MM/DD/YYYY format.Preferred Method of Transportation(Required)Please select how you would prefer to travel to and from Charlottesville for the conference. By Plane By Train By Car Preferred Itinerary(Required)If you selected to travel by plane or by train, please upload a screenshot of your preferred flight or rail itinerary.Accepted file types: jpg, jpeg, png, gif.Full Legal Name(Required)Your full legal name is required for us to book a flight or train ticket on your behalf. If you do not have a middle name, please enter “NONE” in that field. Dr.MissMr.Mrs.Ms.Mx.Prof.Rev. Prefix First Middle Last Date of Birth(Required)Your date of birth is required for us to book a flight or train ticket on your behalf. Please enter your birth date using the format MM/DD/YYYY.Phone number(Required)Your phone number is required by our travel company for communication of any flight or train updates.Known Traveler NumberIf you have a Known Traveler Number you would like to use, please enter it here.Frequent Flyer NumberIf you have a frequent flyer number you would like to use, please enter it here.Amtrak Rewards NumberIf you have an Amtrak rewards number you would like to use, please enter it here.For the purposes of arranging ground transportation to/from the airport or train station, would you like to be put into contact with other presenters arriving or departing around the same time as you?Please note that due to challenges presented by our reimbursement system, we are unable to cover ground transportation for conference presenters. Yes No If you selected to travel by car, please note that you will need to register as a vendor with UVA to receive your reimbursement, and you will need to complete a reimbursement form within 30 days after the conference. Once you have submitted this conference speaker registration form, we will initiate the process to register you as a vendor. In the coming weeks, you will receive an automated email for UVA’s Payment Works that will invite you to complete the process of registering as a vendor.Additional Conference LogisticsAccessibility NeedsPlease let us know if you have any mobility or accessibility needs, so that we can make appropriate arrangements for your travel and during the conference.Dietary Restrictions or Food AllergiesLunch will be provided during both days of the conference, and a reception will be held on Saturday evening. Please indicate if you have any dietary restrictions or allergies we should be aware of when selecting meal options.Online Viewing Release(Required)Note: This agreement appeared when you submitted your presentation proposal. We are presenting it again to ensure you are aware that some attendees may view your presentation virtually. I acknowledge that my presentation may be viewable on Zoom by the virtual conference registrants. Recording Release(Required)Please indicate whether you agree for your presentation to be recorded and published on the eLaboratories website and/or social media for educational purposes. Your choice may be changed at any time by writing us at elabs@virginia.edu. Note: This release appeared when you submitted your presentation proposal. We are presenting it again in the case your preference regarding recording has changed. If at any time you have selected “Presenters DO NOT AGREE,” then we will not publish your recording. ALL presenters AGREE to the recording of their presentation and to the publication of that recording on the eLaboratories or Center for Digital Editing websites or social media. Presenters DO NOT AGREE to the recording of their presentation. Is there anything else you would like the organizers to know?Please enter any questions, concerns, or special requests you may have.I want to receive updates from eLaboratories about new courses, events, and more.(Required) Yes No