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MnSCU and University of Minnesota Distance Learning Initiative

Application Form for January '98 Workshop

Please complete this form and then press the submit button to register for the meeting. Fill out a separate form for each participant. If you have any questions, please contact Linda Halet at (612)626-1890 or email halet@geom.umn.edu

Applications must be received by January 9, 1998.

Preferred Title:   
 Professor    Dr.    Mr.    Mrs.    Miss    Ms.

Mailing Address: 

Phone:             Fax:  

Soc. Sec. Num.:   (needed for reimbursement)
There will be a reception and dinner at the Radisson Hotel Metrodome beginning at 6:30 pm on January 19, 1998. Please make reservations for dinner and/or lodging that night.
I request dinner reservations at the Radison for Monday night.
I request lodging at the Radison for Monday night.

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Comments to: cutler@geom.umn.edu
Created: Monday, 16-Jun-97 16:51:17 --- Last modified:
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