Note: These are only sample forms. The actual registration forms are only available through the "Academic Success" tab of your "my.washburn" account.

Sample Presenter Registration Form
Password:
You must use your my.washburn username to log in, but your password does not have to be the one you use on that system. If you forget your password, this system can e-mail it to you.
Password:
Repeat password (for verification):
Presenter Information:
Last Name:
First Name:
Middle Name/Initial (optional):
WIN (Washburn ID Number, don't include the W): W
Local Mailing Address:
(as would appear on mailing label, don't include name, 200 chars max)
Major:

Class:
Local Phone Number: (XXX-XXX-XXXX)
Alternate Phone Number (optional): (XXX-XXX-XXXX)
Guest Information:
We would like to invite two guests of your choice to the reception following the event. Please provide mailing label information below for the people you would like to invite.
Guest 1 Name & Address (optional):
(as would appear on mailing label, 250 chars max)
Guest 2 Name & Address (optional):
(as would appear on mailing label, 250 chars max)

Sample Presentation Registration Form

Please fill out the form below and select either 'Submit Registration Now' to submit your Apeiron application, or select 'Save Registration Data' to return at a later time to submit your Apeiron application.

Once the presentation has been submitted, no further changes can be made using this system. If changes are needed after the presentation has been submitted please contact at .

After you have submited your registration, you must print out the release form, sign it, and deliver the signed form to ______ at _______.
Mentor/Department Information:
If you have multiple faculty mentors then list the primary mentor here and list the other mentors in the "Additional Information" section at the end of the form. If your mentor's name does not appear here, please send an email to ___________ at ____________.
Faculty Mentor's Dept:
Faculty Mentor's Name:
Presentation Title/Abstract:
For group presentations, only the primary presenter should register the presentation here. Co-presenters should sign up using the "Sign up as a Co-presenter" link on the previous page, after the primary presenter has registered the presentation. The primary presenter will receive a PIN online and via e-mail which they will distribute to the other members of the group.
Title of Presentation:
(300 chars max - please use title capitalization,
should NOT be all lower or all upper case letters!)
Abstract:
(1500 chars max, approx 180 words)

(Please e-mail it to _______________________.)
Is this presentation part of a WTE (Washburn Transformational Experience) for you?
Presentation Type/Needs:

All rooms have a Windows PC with PowerPoint, a projector, and a DVD player.

Special Needs:
        
        
         (Electrical access is limited. Choose only if needed.)

Special Needs:

        
Describe Performance Type
(e.g. Vocal, Poetry, Drama, etc.):

Special Needs:


List the Names of Accompanists that are NOT also Registering for the Apeiron (separate with commas):

Accompanists:

Additional Information:
Please provide any additional information here. If there are presentation times that conflict with your work or class schedule, please indicate them now. If you have multiple faculty mentors indicate that here.
Other Info We Should Know About
(1000 chars max)
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