Please complete the following information to register for the E3 Elsevier Education Event in Annandale, VA that will be held at Northern Virginia CC. You will receive an email confirming your registration in approximately 1-2 weeks.
1.	First Name:
2.	Last Name:
3.	Institution Name:
4.	Address:
5.	City:
6.	State:
7.	Zip:
8.	Telephone:
9.	Email address:
10.	Who is your Elsevier Sales Rep?
11.	What course(s) do you teach?
12.	Are you bringing others to the E3 seminar? (If so, please ask them to register separately): Yes No Unsure
13.	Do you currently use any Evolve products? (Check all that apply) Evolve Resources (free ancillaries) Evolve Courses (formerly known as "Online Courses") Evolve Learning System (course management tools) Evolve Simulations (formerly known as "Virtual" series, i.e. VCE, VMO, VPE) Simulation Learning System TEACH (pre-developed curricula) Evolve Select eBooks Evolve Case Studies Evolve Smart Test Evolve Practice Test Evolve Tutor Other
14.	Do you use online materials currently? Please check all that apply: Completely Online In the Classroom (lab) In a Blended Environment (in classroom and online) Don't use Online Materials
15.	Does your institution use a Learning or Course Management System? Yes No Unsure
16.	If you answered yes to the above question, please indicate which system is used by your institution: Evolve Blackboard WebCT eCollege Angel Desire2Learn Moodle Sakai Other Unsure
17.	Does your institution utilize online testing? Please check all that apply: Evolve Reach - Powered by HESI ATI ERI Kaplan Other Don't use online testing Unsure
Thank you for registering for the E3 Elsevier Education Event in Annandale, VA. We will include room/building locations with your confirmation of registration. We look forward to seeing you on Decmber 4, 2009 from 9:00- 4:00pm! (Registration @ 8:30am)

Contact the questionnaire administrator with any questions or problems.