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MIT Enterprise Forum Viewing Sites: May 2011 Jeff Immelt

1. Viewing Site Participation and Contact Information

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* 1. What is the name of your organization?

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* 2. Please enter the requested information for the main point of contact for your viewing site.

Name

Email address

Work phone

Mobile phone (for contact on night of live program emergency only)

Website

Venue for Viewing Site

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* 3. How does your viewing site plan to take part in the broadcast?

Live web streaming video

Archived webcast

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* 4. If you plan to participate as a delayed viewing site using the archived webcast, what date are you targeting to hold the program?

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* 5. Is this the first time you have participated as a viewing site for an MIT Enterprise Forum broadcast?

Yes

No

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* 6. How many attendees do you estimate will be in attendance at your viewing site?

1-10

11-25

26-50

51-100

101-200

200+

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* 7. Please share any additional comments or points of contact here. Thank you.