Confirm Your Registration

Confirmation deadline is May 25, 2006

For further information, contact Cinzia Cervato

Please download the following medical and emergency information form, complete it, and bring it with you to the workshop in a sealed envelope. Medical Emergency Information Form

Complete the following form and click on SUBMIT to confirm your registration.

Be sure to hit the SUBMIT button before leaving this page or your information may be lost.

Full Name:
.
Name of Institution:
.
First Name for Badge:
.
Email Address:
.
Will you bring a laptop to the workshop?
yes

no

Travel Information

In making your travel arrangements, please plan to arrive in Des Moines, by Tuesday, June 12 and to depart Thursday, June 15. Additional information about travel can be found under logistics.

Travel Method:
I will be traveling by car.

I will be traveling by air.

Date, Airline, Flight #, and Time of Arrival.
.

Date, Airline, Flight #, and Time of Departure.
.
I am interested in sharing ground transportation to the workshop.
I will be renting a car (at my own expense).

Do you have a disability, food allergy, or preference that requires accomodation at the workshop? If so please describe:
.

Do you anticipate difficulty walking moderate distances on campus?
Yes

No

In confirming my registration for this workshop, I agree that any images (still or video) made of me during the workshop may be used on the project website, in printed project publications, and in materials developed by the project. I further agree that my contributions to creative works that emerge from workshop activities (e.g., discussions on the listserv, contributions to the web page, summaries of group discussion, etc.) may be used by the workshop series, PIs, and conveners for development of future workshop materials, for scholarly reports, and for promotion of the workshop series. Attribution for original contributions will be made whenever possible.

I also accept responsibility to cover any costs incurred should I withdraw from participation in the workshop after Friday, May 26, 2006. I understand that arrangements have been made on my behalf that have associated real costs (e.g. logistics, materials), and in many cases, my early confirmation has secured a place that has been denied to other interested colleagues. Exceptions will only be made in cases of extreme personal hardship.

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