TiE2012 Presenter Information Form
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1.

1. Your Name - Last, First

Your Name - Last, First

2. Your CCC Email Address

Your CCC Email Address

3. Home Campus - Select One

Home Campus - Select One

Other (please specify)

4. Department

Department

5. PresentationTitle

PresentationTitle

6. Please enter a brief description of your presentation.

Please enter a brief description of your presentation.

7. Is this a "hands-on" exercise requiring a computer lab?

Is this a "hands-on" exercise requiring a computer lab? YES

NO

8. Please specify if you require these basic hardware components: Computer, Internet Access, Projector, Screen

Please specify if you require these basic hardware components: Computer, Internet Access, Projector, Screen YES

NO

Other (please specify)

9. Please indicate any specific software that you will need to be loaded on your computer

Please indicate any specific software that you will need to be loaded on your computer

10. Additional questions or comments:

Additional questions or comments:

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