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Registration/Survey form for Python Workshop 5

Please fill out the following form if regarding the Python Workshop at the Washington Convention Center on November 4-5, 1996. If you can't attend please indicate the reason why in the first selector box.
Enter 'None' for fields that don't apply.
attending the Workshop.
First Name:
Last Name:
Organization:
Address:
City:
State: (or local province)
Postal Code:
Country: (blank=USA)
Telephone:
E-Mail:
URL:

Are you a PSA member?

Yes No

Which term best describes where you work?

Consultant
Small Business
Large Business (over 250 employees)
Civilian Government
Military
Other

Which phrase best describes your environment for using Python?

Production/Service
Development
Research
Other...

Which phrase best describes how you use Python?

Embedded in applications
Prototyping applications
In development tools
Considering using Python
Other...
If you are planning on giving a presentation:
    Title of paper or presentation:

    Abstract for paper or presentation:

Don't forget to print out the receipt.