Presentation

Please complete and submit this form. Content may be edited for style and will be sent to appropriate media. All entries are subject to verification before release.

Please type all responses in appropriate upper and lower cases. (Not all uppercase, please)

Today's date:		Month January February March April May June July August September October November December Day 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 2003 2004 2005 2006 2007 2008 2009 2010
Personal Information
First Name:		M.I.:
Last Name:
Phone Number (USA):		- -
Email:
Contact Person Information
First Name:		M.I.:
Last Name:
Phone Number (USA):		- -
Email:
About the Presentation
Who sponsored this work?
What is the title of the publication or presentation?
Date of the publication or presentation?		Month January February March April May June July August September October November December Day 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 2003 2004 2005 2006 2007 2008 2009 2010
Time of the publication or presentation?		12 11 10 9 8 7 6 5 4 3 2 1 : 00 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 a.m. p.m.
Where will the presentation be held (include address)?
Do you have a photo or graphic to accompany the release? Yes No
How will this photo be delivered? (Pictures must be 200 resolution or better if emailed)
Describe your findings in 250 words or less. Please try to avoid using jargon and technical language.
Provide in 250 words or fewer the significance or implications of this work.
Press releases are routinely sent to local media organizations and the honoree's hometown. If you would like the release to be sent to other publications, please list them.
Name of publication:
Name of publication:
Please take a moment to check over your entry. When you are satisfied with your answers press the submit button below. The information will be edited and a press release will be sent out. Thank you and good luck with your presentation.