Panelist Registration

The 16th Annual Cherry Creek Diversity Conference - January 31, 2009

Workshop Panelist Registration

Workshop and Time
Please complete every field.

I am registering to sit on this workshop panel
I am able to sit on the panel	One session only, 11:50 am - 1:10 pm One session only, 1:20 - 2:40 pm Both sessions, 11:50 am - 2:40 pm
If you are a high school student, are you interested in participating in the discussion groups from 10:15 to 11:35 am?
	Yes No I'm not a high school student.

Basic Information
Please complete every field.

Your Name
Title or Position
Company or Organization
Business Phone
Cell Phone
Home Phone
E-mail Address

Address
We ask for your address primarily to send material confirming your participation in the conference. If you plan to receive all communication through your workshop organizer, please leave the address fields blank and check the box below.

Please send all materials relating to the conference through my workshop organizer.
Address Line 1
Address Line 2
City
State
Zip Code
This address is:	Business Home

Miscellaneous

Do you give the conference permission to take photographic pictures of you and your workshop?
	Yes No
Do you know of a website for another diversity-related organization you would like to recommend to us? We will possibly list it under 'Resources' on our site.

Questions or Comments