If you are interested in making a presentation at one of our upcoming meetings, please complete and submit this application. You may also submit your abstract online in one of the following formats: PDF, Microsoft Word or Power Point.
	ERG Speakers' Application   Fields with* are required First Name:*   Middle Initial:  Last Name:*  Company:*  . Address:*  .   . City*  . State or Province*  Select State Alabama Alaska Alberta Arizona Arkansas British Columbia California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland North Carolina North Dakota North West Territory Nova Scotia Ohio Oklahoma Ontario Oregon Pennsylvania Puerto Rico Quebec Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Yukon    Zip or Postal Code*  . Work Phone:*  (    )    -   . Alternate Phone:  (    )    -   Email Address:*  . Confirm   Email Address:*  Briefly describe your company's product(s) or service(s):* . Explain how your presentation is relevant to the energy industry and what you hope the ERG participants learn from it:* . Check here if you are wiiling to speak at any of the meetings listed below. . OR . Rank the following meetings in the order you would prefer to make your presentation   2011 Edcucational Symposium:   1st    2nd    3rd    4th    5th    6th . 2011 Fall Technical Meeting:   1st    2nd    3rd    4th    5th    6th . 2012 Winter Technical Meeting:   1st    2nd    3rd    4th    5th    6th . 2012 Spring Technical Meeting:   1st    2nd    3rd    4th    5th    6th . 2012 Educational Symposium:   1st    2nd    3rd    4th    5th    6th . 2012 Fall Technical Meeting:   1st    2nd    3rd    4th    5th    6th Please click the "Submit" one time only. It may take several seconds to process your application.   .
	.ww