NW-HEAT CIO Workshop Registration

Name:
Title:
Institution:
Address:	City State Zip
phone:
fax:
e-mail:

The workshop is held March 2 and 3. Please indicate your attendance:
If you have special dietary requirements (e.g. vegetarian), please indicate:

Will you be spending the night at Sheraton Tacoma Hotel on March 2? yes no
If yes, make sure to call the hotel to reserve a room.

Have you attended other NW-HEAT functions in the past? yes no

Is your institution a member of NWACC? yes no

Is your institution a member of EDUCAUSE? yes no

What is the size of your institution (student FTE)?

What is your IT staff size?

Which services do you adminster? (check all that applies)

Administrative Computing
Instructional Computing
Language Learning Center
Hardware Maintenance and Support
User Training
User Support
Help Desk
Media Services
Web Development

Multimedia Development
Production Service
Videoconferencing
Network
Telephone
Computer Resale
Other:
Other:
Other:

Comments:

For comments or concerns regarding this form, please email pitterk@whitman.edu
Last updated 1/14/2000