NMNWSE Central Chapter EYH Conference - Online form for Presenters and other Volunteers

Online Form for New and Returning Volunteers

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If you are interested in helping with NMNWSE Central Chapter Expanding Your Horizons conferences (CEYH), please complete the following information. After submitting the form electronially, you will be contacted by a Planning Committee member to follow up on your interests. You will also be added to the planning committee listserver if you check that box in the general preference section below (or see the volunteer page for instructions to add yourself).

This form can be submitted at any time. Both new and returning volunteers are welcome to use this form. This form can also be used to request being removed from our distribution, or to request information about NMNWSE membership and actitives.

If you are not directed to a page saying "Form Sucessfully Submitted" after clicking on the submit button, or you do not hear back from us within a week, likely there was an error and we may not have received it - in this case please either email the planning committee directly or print and send a hardcopy of the form to us at CEYH Planning c/o NMNWSE, PO Box 51926, Albuquerque, NM 87181.

YOUR CONTACT INFORMATION:

^*Name: First Last:

^*Preferred contact info: Day Evening Both
^*Phone: ^*Email:
Twitter Handle:
Mailing address (plus fax, pager, cell phone, etc if you wish to provide that):

Alternate contact info: Day Evening Both
Phone: Email:
Mailing address (plus any additional alternate contact information you wish to provide):

^*Best way to reach you? Phone Email Regular Mail
GENERAL PREFERENCES:
Please check all that apply.
I would like to be added to the Central EYH Listserver
I would like to be added to the NMNWSE Central Chapter distribution for other
Albuquerque-area NMNWSE activties
I would like to be added to the NMNWSE statewide Listserver
Please contact me about other NMNWSE activities
Please contact me about NMNWSE membership
I can no longer help - Please remove me from your contact lists and listservers

CEYH PREFERENCES:
Please check all that apply. If you are interested in helping with the Central Chapter EYH as a
conference organizer, workshop presenter, day-of helper, etc, or if you have other comments,
please use the relevant sections below to provide further details.

I would like to help with this spring's CEYH
I am busy this year but please keep me in the loop for CEYH next spring
I would like to be involved with EYH advance planning
I'd like to help on the day of EYH (not as presenter).
I would like to do a Student Workshop
Please enter a catchy title and a brief description of the workshop, the target number of
students, plus any special physical requirements or equipment needs for your workshop.
(AV equipment is very limited. Blackboards, overheads, screens are provided.)
Catchy title: Description: No. of students: Special Requirements:
I am interested in being or would like to suggest a Panelist for the Panel Discussion
on Careers that opens CEYH.
please enter a brief bio, and also contact information if you are suggesting someone else.

I am interested in sponsoring EYH

Badge Information: If you will be attending EYH (as a presenter or other volunteer), please
enter your name, title, employer, and occupation as you would like it to read on your badge
Name: Title: Employer: Occupation:
OTHER COMMENTS
OTHER COMMENTS: Please enter any additional information you wish to provide

CLEAR
^*Required Field