Conference Associate Form

IMPORTANT: Information from this form will be used to create your conference badge, which is required for all conference events. It will also probably be the second thing noticed by conference attendees, one of whom might just be the hiring manager at your favorite company. (You will find out about the first thing they will notice in the form below.) So, please check spelling and capitalization carefully to avoid embarrassment later.

Even more important: Our primary means of contacting you is via e-mail, so ensure that your e-mail address is correct in the form and that your junk-mail filter will accept email from camanager@neurobatics.com. If we don't hear back from you because you miss an e-mail, we assume that you are no longer interested.

Conference Associate Application
* Indicates A Required Field

First Name*:

Last Name*:

Organization:

Professional Title:

Street Address*:

Street Address 2:

City*:

State/Province/Region*:

Postal Code*:

Country*:

Daytime Phone*:

Evening Phone*:

Fax:

E-Mail*:

Confirm E-Mail*:

Age*:
(As of March 9th, 2010)

Inexperienced but enthusiastic (under 18)
Older but wiser and dry behind the ears (18-20)
Between well-aged and ancient (over 21)

What languages do you
speak?* (Please list in your essay any others about which we should be aware.)

Language	Fluent	Some	None
English
Cantonese
French
German
HP 15C
Japanese
Korean
Mandarin
Sign (ASL)
z80 machine
Spanish

What size t-shirt
do you wear? *
(These are our uniform and will be provided for you. They are also the "first thing" mentioned above...)

Mens	Womens
Small Medium Large XL XXL 3XL 4XL	X Small Small Medium Large XL XXL
*GDC Management will make the best efforts to accommodate the T-shirts request for conference associates. Availability in ladies sizes are not guaranteed.

Tell us why YOU would be a great Conference Associate. Questions or other feedback should be emailed directly to Tim and Ian (see above). Resumes will be ignored. (1500 character maximum).