Wednesday, September 10, 2008
    11 a.m. to 2 p.m.
    University Center Mall (outdoors)

Organization/Department Name:
Person Responsible:	First Name Last Name
Street Address:
City/State/Zip:	City -- AL AK AR AS AZ CA CO CT DC DE FL FM GA GU HI IA ID IL IN KS KY LA MA MD ME MH MI MN MO MP MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR PW RI SC SD TN TX UT VA VI VT WA WI WV WY State Zip Code
Email Address:
Phone Number:	Ex. 8124615420
Special Display Needs (Please Check All That Apply):
TV/VCR Easel Electrical Outlet Access
Other Materials Needed:
* Please note, equipment and outlet access will be on a first come, first served basis, depending on availability.
Please include a detailed description of the resources and materials that you will have at your table.
Student Development will provide one 6' x 2 1/2" table and two chairs for your display and distribution materials. If your organization needs additional space please indicate on the form.