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12th Annual Black Family Technology Awareness Day
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2010 Black Family Technology Awareness Day

Questions? E-mail us at fam-tech@rpi.edu

Registration Form

All registered group leaders will need to ensure all participants bring along a signed copy of Rensselaer’s Media Services Release Form to the registration table the day of the event.
Download Rensselaer’s Media Services Release Form (PDF).

(* indicates a required entry)
* Organization, Group, or Family Name
* Total number attending
* Contact First Name
* Contact Last Name
* Street Address
(line 1)
Street Address
(line 2)
* City
* State
* Zip Code
Phone Number
* E-Mail Address
* Confirm E-Mail Address
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How many adults are in your group?
How many children are in your group?
Does your group have any special needs?

How did you hear about this event?
Comments or questions:
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