Application for Participation -- April 10, 2013

Civic Engagement Day

Virtual Living: Technology's Impact on Culture and Learning

I would like to participate in one or more of the following ways (check where applicable):

* All applications are due by March 1, 2013


* Required information
Name/Group: *
Contact Person: *
Phone: *
E-mail: *
Preferred time of day: *
Preferred location: *
Audio/visual needs:  Computer    VHS    DVD    CD    Microphone  
Activity is assumed to be one 50 minute block unless more time is indicated
Do you need more time? If so how much?
Options:
 Performance
 Work of Art
 Other
  Debate
 Presentation
Performance: play, poetry reading, short-story reading, musical performance
Debate: organize a debate on an issue related to the theme
Work of Art: create or present a work of art evoking the theme
Presentation/ Q&A: organize a presentation on a relevant topic, with a question and answer period to follow
Session Title: *
Briefly describe the activity you (or your group) wish(es) to create or present: *