| Thank you for registering with us; we'll contact you soon to talk with
you about your event. |
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| Type of event: (choose only one; See FAQ for explanations) |
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Event Sponsor:
(Department, center or other organization, not a person) |
Name of event:
(no size limit; make it a snappy marketing-type title) |
Location of event:
Change if not Genetics Biotechnology Atrium |
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Please describe your event:
(use up to 250 words) |
Month:
(You can replace what's already here with different content.) |
Year of event
2004 |
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(it's technically possible to include an event not in April, especially if it's in late March or early May. Check with us) |
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Day of Month:
Change if not the 3rd |
When will your event begin?
(You can replace what's already here with different content.) |
When will your event end?
(You can replace what's already here with different content.) |
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Your honorary title
(Dr., etc.) |
Your first name |
Your last name |
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Professional title
(Professor, etc.) |
Organization or Department in contact mail address:
(You can leave this blank if it's the same as the event sponsor above). |
UW Building
Example: Bascom Hall |
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| Room Number |
Street Address:
(for US Postal mail) |
Zip
(Please enter if different) |
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Phone
(with area) |
Secondary phone or FAX
(with area) |
E-mail
(full e-mail address) |
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| Best way to contact you: |
Will you need electricity? |
Will you need a live Internet Connection?
If yes indicate type |
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(Please click one. This mostly applies to exploration stations.). |
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| Will you need a video (TV) monitor? |
Will you need a computer? |
Will you need a video camera for a microscope? |
(Please click one. This mostly applies to exploration stations.). |
(Please click one. This mostly applies to exploration stations.). |
(Please click one. This mostly applies to exploration stations.). |
| Will you need any other equipment, such as video cassette player, cyclotron, radio telescope, etc.? Please list. |
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| Please list the name, affiliation and e-mail address of everyone who will be helping you with your exploration station. |
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(This erases all and you start over.) |
