CHI 98 Audio-Visual Request Form


YOUR INFORMATION

Speaker Name:

Company Name:

Street Name:

City, State, Zip, Country:

Phone Number:

Fax Number:

Email:



YOUR MEETING INFORMATION

Name of Session:

On-Site Contact Person:

Start Date:

Start Time:

Meeting Room (Office Use Only):





AUDIO-VISUAL NEEDS (please specify quantity)

 [  ] 35 mm Projector Package
 [  ] Wireless Remote Control (35 mm)
 [  ] Overhead Projector Package
 [  ] Screen
 [  ] VHS VCR, [  ] 25" Monitor(s), Skirted Cart
 [  ] Laser Pointer
 [  ] Audio Cassette Player/Recorder
 [  ] Computer Data Projection Equipment
 [  ] Flip chart Easel (with paper and 4 color pens)

 [  ] Podium Microphone
 [  ] Lavaliere (clip on) Microphone
 [  ] Table/Stand Microphone
 [  ] Wireless Lavaliere (clip on) Microphone
 [  ] Wireless Handheld Microphone



Please note: CHI98 will make every effort to provide what you have requested but
final equipment decision will be determined by CHI98.


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Return by 2 January 1998 to:
CHI Conference Office
703 Giddings Avenue
Suite U-3
Annapolis, MD  21401 USA

This form is required for PAPER, DEMONSTRATION, PANEL and INVITED SPEAKER
submissions.
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