| Name: _________________________________________ | Contact: ____________ (ph) ____________ (fax) SnailMail: ______________________________________ | ______________ (e)
| |
Representing:_________________________________________________________
| ___self | ___Tribal Administration | ___Tribal Library
| ___parent | ___Tribal Education Project
| ___Head Start
| ___interested party | ___Senior Center
| ___Museum/Archive
| ___vendor/exhibitor | ___Cultural Resource Mgt.
| ___Planner
| ___media | ___Public Library
| ___School Library
| ___Special Interest Library
| ___ University/CC
| | ___State Agency
| ___Fed Agency
| |
Fee:
| ___$40 enclosed | (covers meals/refreshment breaks) (Checks should be made out to Nevada State Library/Five State Project) ___$40 at registration (please reserve meal service for me)
| ___please request vegetarian food service
| ___$20.00/meal at door (I will take a chance seating is available)
| ___I am fasting and will be only absorbing all the wonderful discussion and exhibits.
| ___I HAVE CONTACTED THE ATLANTIS AND RESERVED MY ROOM
| (Rooms must be reserved by December 26 to obtain $43.00 rate) | (Phone: 775-825-4700 or 800-723-6500) ___I will make other overnight arrangements. | | |||||||
Other:
___I would like to volunteer as a conference helper:
___Registration desk ___Session host
___Media Faire table host (play videos)
___I would like to be an exhibitor
___I would like to entertain as a story teller, read poetry, Chautauqua
___My tribal government has a Library Services Plan.
___My tribal government has a Technology Plan
___My tribal government has a Disaster Plan for Records Management.
___I have previously attended a Convocation Committee Meeting.
