Notre Dame Energy Week 2009
Confirmation Form

Please Reply by August 31, 2009

To secure your company, group or organization's participation in Notre Dame Energy Week 2009,
please complete the following form and send any applicable payment to:

Barbara Villarosa
Notre Dame Energy Center
182 Fitzpatrick Hall
Notre Dame, IN 46556

Company/Group/Organization Name

Company/Group/Organization Name

Mailing Address

Contact Person

Telephone

Facsimile

Email Address

Representatives Attending

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Event Participation and Payment Information
Please select the capacity in which you plan to support Energy Week 2009
Quad Display

We will participate in the Quad Display (no cost)
Event Sponsor

We will send a check for $100 (or more) to sponsor an event during Energy Week
(please forward check payable to the University of Notre Dame
to Barbara Villarosa at the address above)

We will donate the following items as giveaways/prizes during Energy Week:
Quantity
Description

Thank you for your support of energy education at the University of Notre Dame!