Concert Hall Research Group

2003 Summer Institute - Saratoga Springs

Professional Student Application

PERSONAL INFORMATION

ADDRESS:_________________________________________________________
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PHONE: ___________________________________________________________

EMAIL: ___________________________________________________________

NAME: ___________________________________________________________
(As you would like it to appear on your badge.)

Would you prefer to be contacted at your work or home address/email? ___________________________________________________________

EMPLOYMENT INFORMATION (attach a short resume, if available)

EMPLOYER: _________________________________________________________

DEPARTMENT: ______________________________________________________

ADDRESS: __________________________________________________________
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PHONE: _____________________________________________________________

FAX: ________________________________________________________________

EMAIL: ______________________________________________________________

INTERESTS AND QUALIFICATIONS:

In the space below, succinctly describe why you are interested in attending the CHRG 2003 Summer Institute and provide an assessment of your qualifications.

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PROFESSIONAL SOCIETY AFFLIATIONS:

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CONTACT INFORMATION:

Please send applications and address any questions to CHRG c/o Robin Glosemeyer at Jaffe Holden Acoustics (see the Contact Information). Application should arrive no later than May 15, 2003.