Cranbrook Institute of Science Presenter Registration 2016 Question Title * 1. Please provide your contact information. Name: Company: Address: Address 2: City/Town: State: -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP: Country: Email Address: Phone Number: Question Title * 2. Please select day(s) you would like to present Wednesday Sept. 14, 2016 8am-12pm 1 needed for this day/time Thursday Sept. 15, 2016 afternoon only 11:30-3 Question Title * 3. Presentation Title Question Title * 4. Presentation Description Question Title * 5. Would you like your presentation inside or outside (weather permitting)? Outdoors Indoors Either is ok Question Title * 6. Do you need tables? If so, how many? Question Title * 7. Do you need access to water? Yes No Question Title * 8. If applicable, please provide details about your water needs. Question Title * 9. Do you need A/V equipment ( we have a limited number of projectors)? Yes No Question Title * 10. Please list AV or other equipment requested. Question Title * 11. Will anyone assist with your presentation? If so, please list their name(s). Question Title * 12. Would you, or someone else from your team like a vegetarian lunch? Yes No If yes, how many do you need for your team Question Title * 13. Comments/Questions? Done