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Test form (based on 2009 SECANT workshop) – not ready for completion yet!
Thank you for registering for the 2nd SECANT Workshop held October 30 & 31 at Purdue University. Please complete the brief form below and submit it. The name you give should be as you would like it to appear on your name badge for the event.
We have a block of rooms reserved at the Purdue Memorial Union Club Hotel for the nights of October 29 & 30, 2008. Please call 1-800-320-6291 by October 15, to make your reservation. Room rates are $92-$110. After October 15, the unused rooms in the block will be released. Please refer to the block of rooms as the Science Education in Computational Thinking (SECANT) Workshop.
<form jtk@purdue.edu|> /* subject → Registration Request */ /* DOKU_ID → thanks */
| First Name | [_ fname _] |
|---|---|
| Last Name | [_ lname _] |
| Affiliation | [_ affiliation _] |
| Department Name | [_ department _] |
| [_ email _] | |
| Homepage URL | [_ url _] |
| Mailing Address | [_ mail _] |
| Phone Number | [_ phone _] |
| Did you attend the 2007 SECANT Workshop? | (* attend08 → Yes,No*) |
| When will you arrive for the workshop? | (* arrive08 → Wednesday evening,Thursday morning,other*) |
|---|---|
| If other, when do you plan to arrive | [_ otrarrive _] |
Line;
| When will you depart? | (* depart08 → Friday after lunch,other*) |
|---|
| If other, when do you plan to depart | [_ otrdepart _] |
|---|
| Special Dietary Needs | (* food → none, vegetarian, vegan, other *) |
|---|---|
| If other, please specify | [_ otrfood _] |
(! submit → Submit !) (. reset → Reset .) </form>
★If you have special needs that workshop organizers need to know about, please contact us.
