On-Line Registration

Workshop Registration must be completed by 20 July 2006

Meeting is by invitation only.

Hotel reservations under the “Science of Learning” block of rooms must be made directly with the Radisson Hotel Hampton, VA by 20 July.

Instructions:

• Fill out on-line registration form (items marked with an * are required) .
• Click on the “Submit Registration” button and you will receive a confirmation via email.
• Print response form for your records.
• If you have already registered, but need to make changes, please email paula.poole@us.army.mil or call (508) 366-7229

Dr. Mr.  Mrs. Ms.   Mil. *
If Military Include Rank *

First Name:
  *

Last Name:
  *

Title
  *

Organization:
  *

Email:
  *

Office Phone:
  * Ext:

Mobile Phone:
 

Fax:
 

Address 1:
  *

Address 2:
 

City:
  *

State:
  *

Postal Code:
  *

How would you like your name and organization to appear on your name tag

Name   Organization  

Workshop Attendance:
(With the exception of keynote speakers, participants are expected to attend all
three days of the workshop.
However, if you have arranged otherwise with Workshop POCs, please uncheck
the days you will not be attending. )

Tuesday 1 August
Wednesday 2 August
Thursday 3 August

There will be a social at the hotel's Signals Sports Grill directly after
the 1 August workshop session (light hors d'oeurves/cash bar).
Do you plan on attending?

Yes No