CRS 2010 Releasing Technology Workshop (RTW) Application

First Name:

Last Name:

Your Title:

Specialty or Discipline:

Affiliation:

Company:

Address 1:

Address 2:

City:

State/Province:

Postal Code/ Zip:

Country:

Telephone:

Facsimile:

Email:

Title of Proposed Presentation:

Name of Presenter:

Title of Presenter:

Do you prefer a One-Hour RTW ($1200) Two-Hour RTW ($1900)?

What type of room set-up do you prefer?
theatre
Classroom
Round-Table Discussion
CRS will make every attempt to accommodate your room set-up preference.

For an extra cost, would you like to provide food and/or beverage during your RTW?
Yes No

If yes, please state your food and beverage preferences and the name and email address of the person to contact at your company to finalize food and beverage details:

Brief Description of workshop:

Prospective Attendees:

Other Email: