The Government-University Research Partnership - Registration Form
REGISTRATION FORM
The Government-University Research Partnership
November 3, 6:30 pm 8:30 pm (Reception) -- November 4, 8:00 am 3:00 pm (Meeting)
University Place Conference Center and Hotel
850 West Michigan Street
Indianapolis, Indiana

Hosted by Purdue University
and
Co-Sponsored by the Committee on Institutional Cooperation,
Indiana University and Indiana University/Purdue University Indianapolis



Please type or print first and last name exactly as it should appear on your badge:

First Name:____________________________________________________________________

Last Name:____________________________________________________________________

Title:_________________________________________________________________________

Affiliation:_____________________________________________________________________

Address:______________________________________________________________________

Address:______________________________________________________________________

Email:________________________________________________________________________

Telephone:___________________________________

Fax:________________________________________

I will attend the reception, sponsored by Indiana University, on November 3, 1999,
6:30 8:30 pm, University Place Conference Center:  Yes______ No_____

I am most interested in exploring the following issues at the meeting. Attach additional sheets, if necessary, and refer to Renewing the Federal Government-University Research Partnership for
the 21st Century for background: /WH/EOP/OSTP/html/rand/index.htm

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

NOTE:
· You are responsible for booking your own hotel reservations. A block of rooms has been reserved at the meeting site: University Place Hotel http://www.universityplace.iupui.edu/, 1-800-627-2700. Please call before October 9, 1999, and reference the CIC/OSTP meeting.
· Indianapolis is on Eastern Standard Time.
· There is no fee for registration
 

RETURN THIS FORM BEFORE OCTOBER 21 TO
Karen Singer, CIC
217-244-7127 (FAX)
302 East John Street, Suite 1705
Champaign, Illinois 61820
QUESTIONS? Call the CIC at 217-333-8475


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