Register for the Conference

If the event is free, why have registration?

The venue has limited seating
We wish to have hand-outs and other materials in sufficient quantities for all attendees
By registering you have the option to join the participant e-mail discussion list leading up to the conference
In the event of schedule changes/weather emergencies you can be contacted and notified

Registration Form

Bold fields are required.
Note: Your personal contact information and email addresses will not be shared with anyone or other organizations.

Please include me on the e-mail discussion list

Please check conference sessions that you will be attending:

I intend to attend all four conference sessions

*I will attend the following conference sessions (check all that apply)*
	Saturday January 7, 2006 Film Screenings: End of Suburbia and Kilowatt Ours
	Saturday January 14, 2006 DVD Speaker Presentations: Alternatives to Oil: Measuring and Evaluating their Viability, Steve Andrews Toward an Economy of Sustainable Energy, John Ikerd Buying Our Future: How Consumers Can Lead the U.S. to the Post-Petroleum Economy, Michael Shuman
	Saturday January 21, 2006 DVD Speaker Presentation — Peak Oil: Implications, Mitigation Strategies and Debt, Richard Heinberg Open Discussion / Show and Tell / Attendee Contributions
	Saturday January 28, 2006 DVD Speaker Presentation — Developing a Local Food System (Community Supported Agriculture) Robert Waldrop Film Screening: Peak Oil, Cuba and Community DVD Speaker Presentation — Creating Alternative Communities

Contact Information:

Name:
E-mail:
Address:
City:
State:
Zip:
Telephone:	(e.g. 765-123-4567)

Note: If you do not wish to register electronically please send a brief note to conference organizer:

Frank Cicela
1205 E Elmore Street
Crawfordsville, IN 47933

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