Earth

 

DIAL

 

Site Map 

Jump to CRLT 

Contact: 
Dave Bartlett 
to Web Master 

 

As the network is a computer managed system, the following information is needed to avoid scheduling conflicts and to allow for accurate record keeping. It is recommended that this form be sent to our office priotr to the registration deadline. Please allow 48 hours for cancellation of an event. AAVS contracts state that events not cancelled 24 hours in advance will be charged. In order to facilitate the scheduling process, please fill this form out COMPLETELY and click submit.

ADDRESS

Name

 First Middle Last

Street

City

State/Province

       Zip/Postal Code:

Phone number

       Fax number:

Email address

 

REQUESTING INFORMATION

Requesting school/business

Person requesting event

# of Participants (incl. leaders)

Site to be scheduled

      Other site(s) connected:

Event facilitator

       Content provider:

Requested date

Date Time to

Request event

Option:

Interactive only
Prefer interactive, but will take view only if not selected
View only

 

 

PAYMENT

I agree to pay

 Event Fee: $
Site line charge, if applicable: $
Line charge for all parties involved, if applicable: $
InterLATA (long distance) charge, if applicable: $

 

INVOICE FOR EVENT SHOULD BE SENT TO
(if different than above)

Name

 First Middle Last

Organization

Street

City

State/Province

       Zip/Postal Code:

 
 

 

Updated: Apr.19.01 
Created: Apr.24.99 

 

[Home] [Vision Athena schools] [DIAL Projects] [DIAL Awards] [Technical Tidbits] [Teachers' Resources] [News Letters] [Site Map]