Technology in and Beyond the Classroom
March 2-3, 2012 – Registration Form

See also the conference overview and the full conference schedule.

Name: _______________________________________________

Phone: ______________________ Fax: __________________

School: _____________________________________________

Address: ____________________________________________

City/State/Zip: _____________________________________

E-mail: _____________________________________________

Conference price includes an optional wine and cheese event on Friday evening, March 2, and breakfast and lunch on Saturday, March 3.

$_____ Attending as non-presenter ($250)
$_____ Attending as presenter ($200)

__ Enclosed is a check payable to: North Carolina Central University
__ Please charge to my __ Visa __ MasterCard

Card No: _____________________________________ Expiration Date: ____ / _____

Print name (as it appears on card): __________________________________________

Print and complete this form and return it with your check or credit card information to:

Logo: North Carolina Central University School of Law. NCCU School of Law
Attn. Tamara L. Talmadge
640 Nelson St.
Durham, NC 27707

For information, contact either: