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The Ethics of Neural Prosthetics

Implementing Change: The Ethics of Neural Prosthetics—

—August 26 - 28, 2007— —University Park, Pennsylvania— —REGISTRATION FORM— —(Please print clearly or type)— —Name (First, MI, Last) _— —Department: — Organization: _ Business Address: _ City: _ State: _ Zip Code: _ Business phone: () FAX: () E-mail: _ How do you wish your name and affiliation to appear on your nametag? (if different from above) _ Fees: All fees are in US Dollars. The registration fee includes handouts, refreshment breaks, and lunch on both days. Registrations received on or before August 7, 2007 @$250 each……………$ Registrations received after August 7, 2007 @$300 each………….…………$ (Please supply the information above for each registrant) Total Fee $ Payment: ( ) Enclosed is a check for the Total Fee above (in $US) payable to: Penn State University. ( ) Charge the Total Fee above to my: ( ) MasterCard, ( ) VISA For credit card payments: Card #_ Expiration date (mo./yr.): Print cardholder’s name as it appears on the card:_ Authorized signature for card: Cardholder’s e-mail address (for receipt):___ If you are paying by credit card, you will receive an e-mail receipt, indicating that the card was charged. Please print and mail or FAX this form to: Ethics of Neural Prosthetics Registration Engineering Continuing Education 301A Engineering Unit C University Park, PA 16802 FAX: (814) 865-3969, Voice: (814) 865-7643 E-Mail: For questions about technical content, contact: Prof. Steven Schiff 0212 Earth & Engineering Sciences Bldg. University Park, PA 16802 Voice: (814) 863-4210 Email:

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