3rd ATAIN/IIN Conference on Aerospace and Space Science

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Please register even if you will not be attending the entire conference duration.

First Name

Last Name

Title

Organization Name

Department

Street 1

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City

State

Zip Code

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example: (555) 555-5555

E-mail

Note: A copy of this form will be emailed to this address upon completion.
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What is your primary organizational association?

	University
	Business
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	Development Nonprofit
	Other

If you selected University, are you a(n)

	Undergraduate student
	Graduate student
	Faculty
	Administrator
	Other

Area of Research Expertise

Will you be having lunch at the conference?

	Yes
	No

If yes, which lunchtime Breakout Session will you attend?

For a full description of these sessions go to Conference Topic Descriptions

Please fill out and send the related form link on the above page.

	Aerospace Technical Advances
	K-12 Education

Special Diet Restrictions

"Taking America to the Moon and Beyond in the Coming Decades" with Col. Kevin Ford (oriented toward K-12 students)
Will you be attending this at 4pm?

	Yes
	No

Following in the "footsteps" of the late Senator David Ford:
Please write down (below) your ideas on how this conference can follow David Ford’s footsteps to help others succeed and make this world a better place. As a result of this conference, what can we do to move Aerospace and Space Science forward for the good of the people of Indiana? (Optional)

Do you plan on attending the 4:30 High Altitude Research Platform Balloon Launch?

Yes