[[Implanting Change: The Ethics of Neural Prosthetics]]

---//Implementing Change: The Ethics of Neural Prosthetics---//


//---August 26 - 28, 2007---//
//---University Park, Pennsylvania---//
//---REGISTRATION FORM---//
//---(Please print clearly or type)---//
---Name (First, MI, Last) _________________________________________________________________---
---Department: ________________________________________________________________________---
Organization: _______________________________________________________________________
Business Address: ___________________________________________________________________
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How do you wish your name and affiliation to appear on your nametag? (if different from above)
_________________________________________________________________________________
Fees: All fees are in US Dollars. The registration fee includes handouts, refreshment breaks, and lunch
on both days.
____ Registrations received on or before August 7, 2007 @$250 each……………$__________
____ Registrations received after August 7, 2007 @$300 each………….…………$__________
(Please supply the information above for each registrant)
Total Fee $__________
Payment:
( ) Enclosed is a check for the Total Fee above (in $US) payable to: Penn State University.
( ) Charge the Total Fee above to my: ( ) MasterCard, ( ) VISA
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If you are paying by credit card, you will receive an e-mail receipt, indicating that the card was charged.
Please print and mail or FAX this form to:
Ethics of Neural Prosthetics Registration
Engineering Continuing Education
301A Engineering Unit C
University Park, PA 16802
FAX: (814) 865-3969, Voice: (814) 865-7643
E-Mail: bmkdo@engr.psu.edu
For questions about technical content, contact:
Prof. Steven Schiff
0212 Earth & Engineering Sciences Bldg.
University Park, PA 16802
Voice: (814) 863-4210
Email: sjs49@psu.ed