![](media/image1.png){width="8.18125in" height="1.0020833333333334in"}

#### REGISTRATION and SPEAKER FORM

##### ADVISORY COMMITTEE ON WATER INFORMATION

**Annual 2004 Meeting**

[**Days Hotel & Conference Center**](http://www.dullesdaysinn.com/)

**2200 Centreville Road**

**Herndon, VA 20170**

**PH: 703/648-5838 FAX: 703/648-5644**

# September 14-15, 2004

**Registration is closed as of 1:00 pm today.\
Note: Please use the tab key rather than the return/enter key to move
from one option to another within this form**

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NAME:**

**ACWI MENBER**

**ORGANIZATION\
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**EMPLOYER:\
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POSITION:**

**ADDRESS:**

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CITY/STATE/ZIP:**

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TELEPHONE: (\_\_\_\_\_\_\_) /\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
x \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**FAX: (\_\_\_\_\_\_\_) /\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

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**EMAIL:**\
**Please add me to the ACWI info email list**

**PLEASE INDICATE YOUR ATTENDANCE AT THE MEETING:**

Day 1 Yes No\
Day 2 Yes No

**PLEASE INDICATE YOUR ATTENDANCE AT The DAY 2 LUNCHEON (included):**

**WILL ATTEND WILL NOT ATTEND**

**Note: If you have any registration questions, Please do not hesitate
to contact Judy Griffin via**

**Phone 703 648-5229 -- fax 703 648-5644 - Email:** jbgriff@usgs.gov

If you are **[not a speaker]{.underline}**, Please email or fax the
entire form to us at the WICP Office.

**Speakers attending the meeting:\
Please complete the following speaker information below**

### Speaker Information 

**(Title of Talk):   **

**Please indicate the day and time you would desire to give your talk.
Toni Johnson will accommodate speaker participates whenever possible.
Naturally, she will make the final decision concerning speakers dates
and times on the Agenda.**

<table>
<colgroup>
<col style="width: 1%" />
<col style="width: 5%" />
<col style="width: 8%" />
<col style="width: 3%" />
<col style="width: 5%" />
<col style="width: 15%" />
<col style="width: 15%" />
<col style="width: 7%" />
<col style="width: 21%" />
<col style="width: 15%" />
</colgroup>
<tbody>
<tr class="odd">
<td></td>
<td><strong>Day 1</strong></td>
<td><strong>AM</strong></td>
<td colspan="2"><strong>PM</strong></td>
<td colspan="5"></td>
</tr>
<tr class="even">
<td></td>
<td><strong>Day 2 </strong></td>
<td><strong>AM</strong></td>
<td colspan="2"><strong>PM</strong></td>
<td colspan="5"></td>
</tr>
<tr class="odd">
<td colspan="4"></td>
<td colspan="2"></td>
<td></td>
<td colspan="3"></td>
</tr>
<tr class="even">
<td colspan="4"><strong><u>Release Talk for ACWI
Website:</u></strong></td>
<td colspan="2"><strong>Yes No</strong></td>
<td></td>
<td colspan="3"></td>
</tr>
<tr class="odd">
<td colspan="4"><strong><u><br />
AV Equipment Available</u>:</strong></td>
<td colspan="2"><strong>(Please check as needed)</strong></td>
<td></td>
<td colspan="3"></td>
</tr>
<tr class="even">
<td colspan="4"><strong>LCD Projector for<br />
PowerPoint Presentations</strong></td>
<td colspan="2"><strong>Carousel Slide Projector</strong></td>
<td></td>
<td colspan="3"></td>
</tr>
<tr class="odd">
<td colspan="4"><strong>Overhead Projector</strong></td>
<td colspan="2"><strong>Handouts only</strong></td>
<td></td>
<td colspan="3"></td>
</tr>
<tr class="even">
<td colspan="4"></td>
<td colspan="2"></td>
<td></td>
<td colspan="3"></td>
</tr>
<tr class="odd">
<td colspan="4"></td>
<td colspan="2"></td>
<td></td>
<td colspan="3"></td>
</tr>
<tr class="even">
<td colspan="4"><strong><u>Presentations on:</u></strong></td>
<td colspan="2"><strong>USB Flash Drive</strong></td>
<td><strong>Zip Disk<br />
(Circle 100 or 250)</strong></td>
<td colspan="3"></td>
</tr>
<tr class="odd">
<td colspan="4"><strong>CD ROM</strong></td>
<td colspan="2"><strong>3.5 Floppy Disk (2HD)</strong></td>
<td><strong>Overhead (as backups)</strong></td>
<td colspan="3"></td>
</tr>
<tr class="even">
<td colspan="4"></td>
<td colspan="2"></td>
<td></td>
<td colspan="3"></td>
</tr>
<tr class="odd">
<td colspan="4"><strong>Laptop:</strong></td>
<td colspan="2"></td>
<td></td>
<td colspan="3"></td>
</tr>
<tr class="even">
<td colspan="4"><strong>USGS (Preferred)</strong></td>
<td colspan="2"><strong>Yours Internet Connection</strong></td>
<td></td>
<td colspan="3"></td>
</tr>
<tr class="odd">
<td colspan="4"></td>
<td colspan="2"></td>
<td></td>
<td colspan="3"></td>
</tr>
<tr class="even">
<td colspan="4"><strong><u>Software Used:</u></strong></td>
<td colspan="2"></td>
<td></td>
<td colspan="3"></td>
</tr>
<tr class="odd">
<td colspan="4"></td>
<td colspan="2"></td>
<td></td>
<td colspan="3"></td>
</tr>
<tr class="even">
<td colspan="4"><strong><u>Software Used:</u></strong></td>
<td colspan="2"></td>
<td></td>
<td colspan="3"></td>
</tr>
<tr class="odd">
<td colspan="4"><strong>Microsoft PowerPoint Versions</strong></td>
<td colspan="2"><strong>2002 2000 97 95</strong></td>
<td></td>
<td colspan="3"></td>
</tr>
<tr class="even">
<td colspan="4"><strong><u>Other:</u></strong></td>
<td colspan="2"></td>
<td></td>
<td colspan="3"></td>
</tr>
<tr class="odd">
<td colspan="4"></td>
<td colspan="2"></td>
<td></td>
<td colspan="3"></td>
</tr>
<tr class="even">
<td colspan="4"></td>
<td colspan="2"></td>
<td></td>
<td colspan="3"></td>
</tr>
<tr class="odd">
<td colspan="8"><table>
<colgroup>
<col style="width: 98%" />
<col style="width: 1%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="2"><strong>Note:<br />
An LCD projector, connected to a laptop, is available at the conference
center. We would appreciate receiving your presentation in advance if
possible (Email attachment, CD-ROM, Zip disk, or a 3.5 inch floppy).
Please also bring your USB Flash Drive or CD disk with you. As a backup,
please print your presentation on a set of overheads and bring them with
you.</strong></td>
</tr>
<tr class="even">
<td colspan="2"></td>
</tr>
<tr class="odd">
<td><strong>Please provide this information to: Carol Lewis, U.S.
Geological Survey,<br />
417 National Center, Reston, Virginia, 20192; Phone 703-648-5676 -<br />
Fax 703-648-5644 - Email cilewis@usgs.gov</strong></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
</tr>
<tr class="odd">
<td><strong>Copies:<br />
We must have at least one hard copy of your presentation for our
official FACA records. Be sure to leave this at the Registration Desk.
If you wish to provide all attendees with a black and white paper copy
or outline of your talk, please bring 75 copies with you.</strong></td>
<td></td>
</tr>
</tbody>
</table>
<p><img src="media/image2.wmf" /><img src="media/image3.wmf" /></p></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td colspan="4"></td>
<td colspan="2"></td>
<td></td>
<td colspan="3"></td>
</tr>
<tr class="odd">
<td colspan="4"></td>
<td colspan="2"></td>
<td></td>
<td colspan="3"></td>
</tr>
<tr class="even">
<td colspan="4"></td>
<td colspan="2"></td>
<td></td>
<td colspan="3"></td>
</tr>
<tr class="odd">
<td colspan="4"></td>
<td colspan="2"></td>
<td></td>
<td colspan="3"></td>
</tr>
</tbody>
</table>

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