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Fourth Annual Dartmouth Symposium on Substance Use

Date:

May 9, 2008

Time:

8:30am - 4:30pm

Location:

Collis Center
Dartmouth College
Hanover, NH 03755

To register, simply fill out and submit this form by May 1, 2008. Space is limited. Registrations will be accepted on a first-come first-served basis. Early registration is appreciated.

Note: Registration is for one person only. Each person must register individually. Fields marked with an asterisk (*) are required.

*First Name:

*Last Name:

Institution:

Department:

*Address:

*City:

*State/Province:

*Zip Code:

*Phone:

Fax:

E-Mail:

Space will be available for the distribution of related brochures, posters, and other educational materials.

Please indicate if you intend to bring materials: Yes No

If yes, please specify so that we can make the appropriate accommodations for your materials.

Travel directions and listings of local area dining and lodging accommodations can be found at: http://www.dartmouth.edu/apply/visiting/

Last Updated: 3/28/08