Joint Mathematics Meeting Panel Request Form

Session Description: (150 words or less)

Organizer(s):names(s) and affiliation(s)

Organizer(s) Complete Address (postal, e-mail, telephone, and fax)

Panelists/Participants: names(s) and affiliation(s)

Sponsoring MAA Committee, SIGMAA, or Group:

Preferred Afternoon (Day #1; Day #2; Day #3; Day #4):

First Choice:

Second Choice:

Third Choice:

Conflicts to Avoid:
(Note that committee meetings are scheduled in October)

AV Equipment Required:
(besides the standard overhead projector and screen)

If this session has been offered at an MAA National Meeting in the past three years list the meeting and dates.