Section A - General Information

Home Mailing Address in the event we need to ship something (no PO Box)

Section B- Room Information

Room Accommodation Details:

Guest Stay - a complimentary room is provided from Thursday, June 4, 2026 (check -in) through June 6, 2026 (check-out). Single person room occupany only. No plus ones.

Section C - Upload requirements

IYou are required to upload your headshot, bio, and abstract

Section D - Alternative Point of Contact

Optional (in the event we need to acquire or provide additional information)

Section E - Media Release Form

I hereby authorize the HBCU BUSINESS DEANS ROUNDTABLE (the “Organization”) and its officers, executives, members, and agents, to photograph, film, or video-tape me. 

​

I understand that any photograph, sound recording, motion picture, or video taken of me under this assignment is for the purpose of collecting and/or representing factual information in the interest of serving the Organization’s mission and agenda for promoting/communicating activities, events, or other interests. 

​

I hereby assign to the Organization all rights, title, and interest, including copyright, in and to any and all such photographs, sound recordings, motion pictures, or videos, and I hereby irrevocably authorize the Organization, its officers, executives, members, and agents, without limitation, to reproduce, copy, sell, exhibit, publish, or distribute any and all such photographs, sound recordings, motion pictures, or videos in perpetuity for the purposes expressed above. 

​

I further release and forever discharge the Organization, its officers, executives, members, and agents from any and all claims and demands arising out of or in connection with the use of said photographs, sound recordings, motion pictures, or videos, including but not limited to any and all claims for invasion of privacy, defamation, or infringement of copyright. 

​

I have read and understood the provisions of this agreement and understand that I am free to obtain advice from legal counsel of my choice, at my expense, to interpret these provisions. By signing below, I acknowledge that I have freely and voluntarily entered into this agreement.