Registration Form

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	NODE REGISTRATION

Registration Form

Node name:
Institution name:
Department or program sponsoring the node

Name: Email: Active Worlds ID(if available)

Name: Email:

Name: Email:

Number of people that will be accomodated at the node

Do you invite people outside your department?

If so, how many seats available?

Number of people that will be accomodated at the node
Do you invite people outside your department?
If so, how many seats available?

Contact Information (enter one or both)

Url

Email

Your connection

Your connection

Describe your group

Any additional activities occurring at your node during the conference?

Name:	Email:	Active Worlds ID(if available)
Name:	Email:
Name:	Email:

Describe your group
Any additional activities occurring at your node during the conference?