Registration Form for Maryland Bicycle Symposium

Maryland Bicycle Symposium
Wednesday, February 4, 2009, 8:30 am to 4:00 pm
President's Conference Center East, Miller Senate Building
Annapolis, Maryland

Registration Form

I plan to attend the 2009 Maryland Bicycle Symposium.
(For more info on the Symposium, see http::/ohbike.org/symposium.)

I would like to be listed in the 2009 Bike-Ped Directory.
(You might already be in the online directory at http://ohbike.org/mbpac/directory. If you are there, just let us know if there are any changes.)

My Organization would like to have an exhibit at the Symposium.
(There is no charge for exhibition space, although a contribution to One Less Car to help pay expenses would be greatly appreciated.)

My Organization would like to be a partner organization with One Less Car in sponsoring the Symposium..
(Partner organizations will be listed on the letterhead of letters sent to elected and government officials inviting them to the Symposium. There is no charge for being a partner organization, although a contribution to One Less Car to help pay expenses would be greatly appreciated.)

First Name

Last Name

Job Title or Position

Department

Organization

Organization's Web site URL

Street Address

City

State

Zip

Work Phone

Home Phone

E-mail

Maryland Legislative District
(lookup your district and representatives)

Comments or Additional Info

		I plan to attend the 2009 Maryland Bicycle Symposium. (For more info on the Symposium, see http::/ohbike.org/symposium.)
		I would like to be listed in the 2009 Bike-Ped Directory. (You might already be in the online directory at http://ohbike.org/mbpac/directory. If you are there, just let us know if there are any changes.)
		My Organization would like to have an exhibit at the Symposium. (There is no charge for exhibition space, although a contribution to One Less Car to help pay expenses would be greatly appreciated.)
		My Organization would like to be a partner organization with One Less Car in sponsoring the Symposium.. (Partner organizations will be listed on the letterhead of letters sent to elected and government officials inviting them to the Symposium. There is no charge for being a partner organization, although a contribution to One Less Car to help pay expenses would be greatly appreciated.)

First Name
Last Name
Job Title or Position
Department
Organization
Organization's Web site URL
Street Address
City
State
Zip
Work Phone
Home Phone
E-mail
Maryland Legislative District (lookup your district and representatives)