Wednesday, March 11, 2009

Registration for Spring AT Symposium

REGISTRATION FORM

INTERNATIONAL NETWORK OF APPROPRIATE TECHNOLOGY

APPROPRIATE TECHNOLOGY SYMPOSIUM AND FAIR

“TECHNOLOGY TO EMPOWER PEOPLE”

April 10, 2009

BLACKBURN CENTER, HOWARD UNIVERSITY

Name Badge and Mailing Information (use a separate form for each person)

Name: ________________________________________________

Badge Name: _________________________ (this name will appear on your name badge)

Title:__________________________________________________________________

Department/Unit: ________________________________________________________

Institution/Organization:___________________________________________________

Mailing Address: ________________________________________________________

City______________________ State/Province:________________________________ Country________________________ Postal Code___________________

Work Phone: ____________________ FAX: ______________________________

e-mail address________________________________________________________

Conference Registration Category (PLEASE CHECK ONE)

Category 1: Appropriate Technology Demonstration Project _____

DEMONSTRATION PROJECT TITLE:______________________________________

_____________________________________________________________________

_____________________________________________________________________

Category 2: Appropriate Technology Project Poster _____

PROJECT POSTER TITLE:______________________________________________

_____________________________________________________________________

_____________________________________________________________________

Category 3: Funding Agency and/or Sponsor _____

AGENCY/SPONSOR NAME______________________________________________

_____________________________________________________________________

Appropriate technology demonstrators will be provided a 6 x 3 ft table and a 110-V outlet.

o Presenters will have a laptop and LCD projector at their disposal and may bring presentations on a USB memory stick.

o Poster presenters must bring their own stand-alone poster display.

Please note below any special requirements you may have:

_____________________________________________________________________________

____________________________________________________________________________

PLEASE E-mail completed forms by March 23rd, 2009 TO jtrimble@howard.edu

Project, Paper or Poster Summary (or Abstract) (150-300 words)

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