Honoree Questionnaire Every honoree is responsible for (1) completing the questionnaire and (2) uploading one electronic passport-style, head shot photograph as well as three to five photos at work or out in their field of science. Please do not submit the form until you have all of the information and materials required. All Union honorees must submit the information and materials required by Friday, 13 September 2019. 1. Please list your name as you would like it to appear on your presentation piece and all Honors Tribute advertisements.*AGU can accommodate accent marks/symbols upon request (e.g., Danica Marcía Williams).2. Please provide the phonetic pronunciation of your name.*For example: Leah= LEE-ya; Bland= Bland [rhymes with sand] Danica= Dye-KNEE-ka [emphasis on the second syllable]; Williams= Will-YUMS3. Please provide your institution affiliation.* 4. Your attendance at the Honors Ceremony, Wednesday, 11 December.*YesNo5. Your attendance at the Honors Banquet, Wednesday, 11 December.*YesNo6. Would you like to reserve a banquet table? Please note that a table seats 8 comfortably or up to 10 snugly. We are unable to seat more than 10 people at a table.*YesNoNot attending the banquetIf yes, how many tables?7. If you are participating in any Honors Tribute events, please indicate any special needs.(i.e., dietary, impairments, etc.)8. Please upload an electronic passport-style (headshot) photo.*This formal photo will be used in the Honors Banquet Program Book. Photo submission requirements: JPEG, TIF, or PDF format (file extension), 4” Height x 4” Width, and at least 300-600 dpi (dots per inch).Accepted file types: jpg, tif, tiff, pdf.9. Please submit between three to five photographs/still images of you working in your field of science or a representative image of your scientific field. Please refrain from providing photographs with institutional logos.Photo submission requirements: JPEG, PNG, TIF or PDF file format (file extension), 2000w x 1500h minimum dimensions or 72 dpi (dots per inch).Accepted file types: jpg, png, tif, pdf.Accepted file types: jpg, tif, tiff, pdf.Accepted file types: jpg, tif, tiff, pdf.Accepted file types: jpg, tif, tiff, pdf.Accepted file types: jpg, tif, tiff, pdf.Please note that you should only submit photos to which you personally own the copyright, or for which you have secured—in writing—the owner’s permission to give to AGU for use in a video that will be displayed during the Honors Ceremony, as well as in various other media used by AGU, including the Union’s YouTube channel and other marketing and web-based content.CommentsThis field is for validation purposes and should be left unchanged.