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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