Name of Presenter * Biography of presenter or Link to Online Biographical Information: * Contact Email * Contact Phone Number * Name of Contact (if different than presenter) Speaker's Professional Title/Affiliation * Date of lecture/presentation (if known) Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20152016201720182019 Title of Presentation/Lecture * Location of lecture/presentation (if known): Description of the presentation: * Will the presentation be given in English, Spanish or Portuguese? * If the presentation will not be given in English, will a translator/interpreter be provided? Will you require a/v equipment? * If so, please indicate what you will need, i.e., projector, screen, audio, laptop. Please note: if you bring your own laptop and it's a MAC, please bring the appropriate adaptor. Are you willing to possibly be videotaped for viewing on the LACIS YouTube Channel and local access cable? * Do you need a complimentary parking pass? * Mailing Address for Parking Pass: Please provide a photo of yourself or of something related to your presentation. * Files must be less than 4 MB.Allowed file types: gif jpg jpeg png. Please list any co-sponsors of this lecture. Additional information or needs you wish to share.