Conference Registration Form

The William and Flora Hewlett Foundation 2007 OER Conference

Monday-Wednesday, March 26-28, 2007
Casual Attire
Rice University, Anne and Charles Duncan Hall
6100 Main Street, Houston, Texas

This form must be completed separately for each attendee to provide an accurate account for catering servcies and program materials to be distributed.

Required field(s) are indicated by an *.

Salutation	None Dr. Mr. Mrs. Ms. Miss
* First Name
Middle Initial
* Last Name
Name for Badge
Title/Position
Department/Center
Institution/Company
* Address1
Address2
* City
* State/Province	Outside US/Canada AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY AB BC MB NB NL NT NS NU ON PE QC SK YT
* Zip/Postal Code
Country
Daytime Phone
Fax
* Email
Assistant's Email
Project URL
Short Bio
Comments/Special Needs

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This conference is supported by The William and Flora Hewlett Foundation at Rice University
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