STUDENT VOLUNTEER APPLICATION FORM


Name                                    [  ] Male   [  ] Female


Address


Daytime telephone (include international code)

Home telephone (include international code)

Fax (include international code)

E-mail address

Have you served as a CHI Student Volunteer before?

[  ]yes      [  ]no  If yes, indicate which year(s):

Do you have any special skills or experience you think 
would be helpful to CHI 96?

What languages other than English do you speak well enough 
to offer assistance to non-native speakers of English?

Do you need housing at the conference?      [  ]yes     [  ]no

Name of University/School

Student status as of April 1, 1996
[  ]undergraduate   [  ]master's student   [  ]doctoral student

University/School Address



You MUST show proof of your student status when you register
at the conference.  

This may be in the form of a dated student identification 
card or a letter from your University/School.