2008 Summer Workshop

Hosted by:

Danville, Virginia

Online Registration Form

"Culture Clash: Evolving a Community Through Advanced Technology"

June 5 & 6, 2008

If you are registering multiple people from the same institution, please fill out a form for each person.

Participant's Name

Title

School/Company 

Address 

City       State  ALAKAZARCACOCTDCDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY  Zip Code 

Phone    Fax   

Email    

Payment Amounts:

$175.00 for the first person to register from an NCATC member organization

$150.00 for each additional "Team Member" registration from the same NCATC member organization

$250.00 for each Non-Member

Total: $*

*The registration fee includes workshop materials and meals at the workshop.

Payment Options:

Will send check payable to NCATC

Bill me at address shown

Use P.O. #  and bill me

Will pay online (opens a separate page)

Checks should be mailed to:

NCATC

601 Lake Air Drive

Waco, TX 76710

For questions or comments, please call (708) 326-2509 or email for assistance