Budget Request Form - Indiana Music Teachers Association

First/Last Name *

Institutional Affiliation (if applicable)

Member Type *

Non-collegiate Member

Collegiate Member

Email *

Mailing Address *

Country

City

State

Zip code

Phone *

Proposal Title *

Comments

Session Description *

35 words or less

Preferred session length *

Collegiate Forum (15-minutes)

Half (25-minutes)

Full (50-minutes)

Proposal Abstract *

250 words or less

Tech requests/needs *

(this does not affect your application, it is only so we have your information if you are selected)

Brief Bio of each person involved (35 words or less each) *

Presenter 1

Presenter 2

Presenter 3

Headshot *

Presenter 1

Presenter 2

Presenter 3

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