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Please answer the following additional questions to help us prepare for the event.

Conference Directory
	*To facilitate networking among conference attendees, we will provide all registrants with a directory of conference participants that includes the contact information you've provided. Please let us know if you would like to be included in the directory. Please select response Yes No
	*Name as it should appear on badge:
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	Are you attending as a representative of this organization? Yes
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Survey Questions
	How did you hear about the National Conference for Media Reform? Please select response Print Ad Email from Free Press Listserv or email from other organization Free Press Website Other Website Brochure/flyer Personal Contact Other
	From which magazine, web site, listserv, organization etc. did you hear about the conference?
	Are you currently active in media reform work? Please select response Yes No
	Have you attended a previous National Conference for Media Reform? Yes, I attended the 2003 Conference in Madison, Wisconsin Yes, I attended the 2005 Conference in St. Louis, Missouri Yes, I attended the 2007 Conference in Memphis, TN No, the 2008 Conference will be my first
	How much do you know about media policy issues? Please select response Beginner Intermediate Advanced
Demographic Information The following optional demographic information will help us better understand who will be attending the conference and help us plan to meet your interests and needs.
	Occupation:
	Gender
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	Age Group under 25 years 25-40 years 41-54 years 55 years+
Arrival Information
	I will arrive for the conference on: Please select response Wednesday, June 4 Thursday, June 5 Friday, June 6 Saturday, June 7 Unsure
Special Accommodations Please let us know about any special requests. We will make every effort to accommodate your needs and would appreciate at least three weeks advance notice so that we may make appropriate arrangements.
	Special Accommodations Interpreting services (list language below) Closed Captioning services (available for plenary sessions only) Sighted Guide Wheelchair/Mobility Assistance
	Other/Additional Information: