REGISTRATION FOR WORKING GROUP ON ORGANIZING AND THE ACADEMY
[If you are a community organizer or leader, please do not use this form, instead go here.]
[If you wish to register on-line, go here]
Otherwise, please print out, complete, and return to:
(216)687-9203,
Fax (216)687-9314
E-mail: r.kleidman@csu-e.csuohio.edu
Name:______________________________________________________________
Organization:__________________________________________________________
Address:_____________________________________________________________
Title or Position:_______________________________________________________
Phone: ______________________ .....Fax:_________________________
E-Mail:______________________________
Please describe your experience, if any, and interest in collaborative work:
What would you like to accomplish at the Working Group?
(Note: Please also complete and return to UC Davis the advance registration form for the Collective Behavior and Social Movement workshop, and, if you wish, the University Accommodations form)