Meeting +Workshop Request Form

2016
Meeting + Workshop
Request Form
12-18 MARCH | FAIRBANKS, AK, USA
assw2016.org
Your contact information
Full name
Email
Special instructions or additional information
Phone
Group
Meeting information
Title
Your preferred date and time
Date
Start time
End time
Shared breaks and meals will be scheduled at a later date. You should anticipate 30 minute
morning and afternoon breaks, and a 90 minute lunch break.
Purpose of meeting
Please e-mail this form, along with
any questions or requests for
more information, to:
Estimated number of participants
Type of meeting space
Auditorium style
Round-table discussion
Classroom
Webconference Additional costs apply
Teleconference Additional costs apply Equipment needed (check all that apply)
Video projector
Speakers
WiFi (wireless) internet
Ethernet (wired) internet
Other (DVD, etc.)
Will meeting be open to the public?
Yes
No
Does this meeting have any foreseeable conflicts with other meetings that will be
scheduled during ASSW 2016?
Tohru Saito, Special Events Manager
tsaito@alaska.edu
+1-907-474-1544
Thank you. We will follow up with requests within
two weeks of their submission. We will do our best
to accommodate all meeting requests.