Piedmont Crossing

Clinic Form

Instructions

Thank you very much for offering to present a clinic at the upcoming MER Convention.

Below you will find a form that will provide us with most of the information we will need to schedule and publicize your clinic.

We are going to try to copy the information directly from the completed form to the web page and convention booklet. To enter information on this form, use the mouse, tab key, or arrow keys to move from one field to the other. Type in the appropriate information, or check the box.

If you have a picture associated with the clinic, please enclose it with the email; JPG format preferred. Please use the naming convention LastNameClinicTitle for both the form and the picture. You can run all the words together using capitalization to indicate the beginning of a word or use an underscore, but please no blanks in the names.

Clinic Registration Form

Piedmont Crossing
MER 2011 Fall Convention
October 27 – 30, 2011

Please complete this form on screen, then press the submit button below.

Personal Information
MMR        
First Name: Last Name: Co-Presenter Day Phone Evening Phone
Address: City: State: Zipcode: Mobile Phone: E-mail:

Clinic Descriptive Information
Picture Attached   Hands-On
Clinic Title:
Clinic Description:
Fee $ Other:

Clinic Requirements
Demonstration Table Attendee work tables Table protection (newspaper)
Computer Projector VuGraph projector  
Other Requirements:

Other Information
Other Information:

 

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Home page:

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http://trainweb.us/cpd13/mer11/clinicform.html

Last Updated:

June 23, 2010

Webmaster:

Robert Rousseau (Email to Rob)

This page and all contents are Copyright 2010–2011 by the Carolina Piedmont Division 13, NMRA MER.
(CPD13 is a Not-For-Profit Corporation incorporated in North Carolina.)
The various logos and heralds shown here are the property of their respective organizations.

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