StStW On-Line Registration Form

Ships to Save the Waters

On-line Registration Form

Your ideas will help shape new collaborative approaches in education and advocacy for our waters.

Please register for the conference on-line so that we can tailor the event to your interests.
Take a moment to complete the survey and registration below and submit.

Are you interested in attending the Conference?		No Yes

What features of the event are you most interested in?
What additional features would you like to see?
Please describe any alliance-building experiences you have had:

Are there specific waterways that you would like to focus on?		Long Island Sound Rhode Island Sound Narragansett Bay Buzzards Bay and Islands Cape Cod Bay Massachusetts Bay Doesn't Matter
If we have enough persons from other regions represented we can look at other areas. Is there some other Bay or region you would prefer to design around?
Would you prefer to work on a team looking at a 'virtual' collaborative through a web-based interactive site for organizations, schools and teachers?		No Yes
Please indicate for each area:		Rate your knowledge level 1 to 5 (lowest to highest)
		1 2 3 4 5
Shipboard Programs:
Small Boat Programs:
Watershed Education:
Environmental Education:
Outdoor Education:
Adventure Training:
Public School Teaching:
Environmental Advocacy:
Environmental Protection:
Local Boards and Commissions:
Commercial Fishing:
Agriculture:
Boat Building:
Programs for Youth:
Counseling:
Strategic Planning:
Architecture and Design:
Communications Technology:
Web Site Design:
Are there any other strengths you have you would like to name?

Are you a member of a participating organization?		No Yes
Which one(s)?
First Name:
Last Name:
Organization:
Address 1:
Address 2:
City:
State:
Zip Code:
Country:

eMail Address:
Would you like to be placed on our eMail list?		No Yes
Should we mail a briefing book to you? (Available in late April. Download from main page, if possible, to save paper)		No Yes

Additional Comments:

Thank you for taking time to send in this registration. Send an email if you need more information. [Back to StStW Main Page]