CCWC 2015 Get Them Coming to Your Blog/Website with Megan Breedlove
Application due no later than April 1.

Date:	mm/dd/yyyy format
Title:
First Name:
Mid Init:
Last Name:
Address:
City:
State:	Select ** -- **Blank** AK -- Alaska AL -- Alabama AR -- Arkansas AZ -- Arizona CA -- California CO -- Colorado CT -- Connecticut DC -- District of Columbia DE -- Delaware FL -- Florida GA -- Georgia GU -- Guam HI -- Hawaii IA -- Iowa ID -- Idaho IL -- Illinois IN -- Indiana KS -- Kansas KY -- Kentucky LA -- Louisiana MA -- Massachusetts MD -- Maryland ME -- Maine MI -- Michigan MN -- Minnesota MO -- Missouri MS -- Mississippi MT -- Montana NC -- North Carolina ND -- North Dakota NE -- Nebraska NH -- New Hampshire NJ -- New Jersey NM -- New Mexico NV -- Nevada NY -- New York OH -- Ohio OK -- Oklahoma OR -- Oregon PA -- Pennsylvania PR -- Puerto Rico RI -- Rhode Island SC -- South Carolina SD -- South Dakota TN -- Tennessee TX -- Texas UT -- Utah VA -- Virginia VI -- Virgin Islands VT -- Vermont WA -- Washington WI -- Wisconsin WV -- West Virginia WY -- Wyoming
Zip:
Day Phone:
Night Phone:
Cell Phone:
Email:
Website:
Blog:

1. Please provide the URL for your website/blog:

How long has it been up and running?

2. Are you your own webmaster? Select Yes No

If someone else is your webmaster, will you have access to this person's help during the time you are in Colorado? Select Yes No

3. Will you have access to a laptop for the entire conference? Select Yes No

If not how much access will you have?

4. Are you willing to prepare the answers to a few questions before the conference? (These questions will relate to your website and will help get you started thinking along the lines of what we will be going over in the clinic.) Select Yes No

5. Are you willing to put in some work in between clinic sessions in relation to the material we discuss that session (such as considering goals, refining certain aspects of your site, etc.)? Select Yes No

6. Please list three questions/topics you would like to see addressed during the clinic.

Question/Topic 1

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Question/Topic 2

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Question/Topic 3

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