Convened by Dr. Toyin Falola • Coordinated by Matthew Heaton

Hotel Registration Form
Venue
Holiday Inn Town Lake
20 North IH-35 Austin, TX 78701
(512) 472-8211

Welcome 2005 Conference Participants!

We are delighted to financially cover accommodations for our conference participants that are either:

a) graduate students from anywhere in the world

b) participants (professors and graduate students alike) coming from Africa.

The Holiday Inn is holding rooms for us that can accommodate 2 to 3 people per suite. If you would like to take advantage of this offer, please fill out the form below as completely as possible. By completing this form, we can register you into the hotel on your behalf. In other words, there is no need for you to contact the hotel directly because we are doing it for you.

We will be rooming professionals with professionals and graduate students with graduate students unless indicated otherwise in the Roommate Preference field.

By clicking on the “Send” button you are sending your form to me to be processed. If you make a mistake after hitting “Send” you can submit a new form and indicate this in the “Additional Remarks” field.

As always, please feel free to email me if you have any questions.

Sincerely, Matt Heaton


Please fill out this form and we will submit the information to the hotel on your behalf.


Name:


Gender:


Address:


City:
State: Zip Code (USA only):

Country:


University/Institutional Affiliation:

Phone Number: Fax Number: Email Address:

Are you a Graduate Student? Yes No

Exact Nights of Stay in Austin(check all that apply):
Thursday Night, March 24
Friday Night, March 25
Saturday Night, March 26

Roommate Preference (If you prefer to name someone as a roommate):

U.S. Social Security Number (non-US residents please enter Passport ID Number):


Additional Remarks:



(Note: This offer does not include room service, phone calls, or any additional expenses pertaining to the hotel)

Press to submit information. Press to go back to the home page without sending information.