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Agency Forum Application

Deadline to reserve meeting space is May 15, 2005.
To ensure that information about your Agency Forum is listed in the 2005 NTP Registration Book,
your completed application must be received by February 15, 2005.
*Indicated fields on this form must be completed.

*Agency Name:
*Key Contact Person:
Title:
Street Address:
Suite # or Mail Stop
City:
State:
Zip:
Phone:
Fax:
*E-mail:
Today's date:
   
Date/Time Requested:
 Monday, July 18    All Day
Tuesday, July 19    All Day 		AM Only
AM Only		 PM Only
PM Only
  Space is limited and will be assigned on a first come, first served basis.
   
Expected Number of Participants:
 25 or less,     26-50,     51-100,     101 - 200,     Other (please specify)
Explanation of Other, if box checked above:
   
Room Set-up:
 Theater,    Classroom,     Other (please specify)
Explanation of Other, if box checked above:
   
Head table required?:
 Yes     No
If yes, specify number to be seated:
Speaker podium required? Yes     No
 
Audio/Visual, equipment or special room needs:
The following A/V equipment will be included in all rooms at no charge to the agency:
Overhead projector and screen
One easel with easel pad and markers
One microphone
  Fees: FEW provides agency forum room at no expense to the agency.
Additional A/V equipment is available at agency's expense and can be arranged for through FEW. Food service is available at agency's expense and by using a separate form provided by FEW.
Cancellation: If agencies cancel their forums less than 10 days prior to the event, fees* may be assessed.
(*If FEW incurs costs for rental of A/V equipment or is unable to use room for other events)
Please contact Agency Forum Representative directly for any need forms or guidance.
Additional information or comments:
   

 

2005 NTP Agency Forum participation information can also be
faxed to: FEW 2005 NTP, Attn: Jean Parker, Agency Forum Representative, at 202-690-2345.
Ms. Parker's telephone number is 202-401-1458.
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