Date of Request* Date Format: MM slash DD slash YYYY Please check if you would you like to apply for AIA LUs also. AIA LUs This form must be completed by the sponsoring organization (ie. IES Section), at least one month prior to the presentation date. Each presentation must be registered separately; i.e., if you are presenting the same course on two different dates, a request form must be submitted for each presentation. You may be asked to provide a PDF of the presentation draft.Start Date:* Date Format: MM slash DD slash YYYY End Date:* Date Format: MM slash DD slash YYYY Event Start Time:* : HH MM AM PM Event End Time:* : HH MM AM PM Select Time Zone:*-- SELECT TIME ZONE --UTC-3 Atlantic Time ZoneUTC-4 Eastern Time ZoneUTC-5 Central Time ZoneUTC-6 Mountain Time ZoneUTC-7 Pacific Time ZoneUTC-8 Alaska Time ZoneUTC-10 Hawaii Time ZoneEvent Location:*Title of Program:*Sponsoring Organization (ie. IES Section):*Presenter(s):*First NameLast NameEmail Click + symbol to add additional presenters.Program Coordinator:* First Last Email* Number of Hours of Instruction:*Please enter a number from 1 to 200.Brief Description of Presentation: (Required for initial request)Learning objectives to be achieved. Each program must have at least four (4) learning objectives clearly stated to indicate what new knowledge or skill participants will gain from the program. These should be clear actionable statements of what you want the attendee to learn and must be clearly defined and communicated to participants in meeting announcements and at the beginning of the program.Please list the learning objectives below (minimum of 4). (Required for initial request) Click + symbol to add additional objectives.Program/Presentation Level (select one) (Required for initial request)Basic Awareness: teaches participants the elements of light and vision and their relationship to living spaces and perception.Intermediate Skills: provides participants with the knowledge and skills required to solve problems in specific areas of lighting.Advanced: teaches participants how to apply knowledge to complex design problems, about newly emerging areas, or about highly specialized subject areas.Registration Fee: (What you are charging to attend)AIA LU-HSW InformationAIA - Health Safety and Welfare (HSW) (Check if applicable) Heath Safety Welfare List topics that qualify for AIA/HSW. (HSW topics must be at least 75% of program content.) Click + symbol to add additional topics.