| Alexander von Humboldt Conference 2001 Registration Form | |
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Please print name as it will appear on program Institutional Afilliation Mailing Address City, State/Country, ZIP List visual or sound equipment you may need for your presention Mark your presentation's language:  English Spanish
Will you bring your books for the Book Fair? YES NO
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Business Phone |
Home Phone |
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E-mail (required) |
FAX |
| On-Campus Lodging Information: | To reserve on-compus lodging, guest must include a registration fee by the deadline, March 15, 2001. |
Conference participants may choose to stay in Cypress Hall that houses 230 participants. These suites have only one complete bathroom per apartment and up to 7 guests may be housed in each apartment. All conference guests will be charged a per person, per night rate of $45.00 for a double room or $50.00 for a single room. This rate includes a bed and bath linen package, and three meals a day. |
| Dates of occupancy: |
Arrival date |
Departure date |
| Please select accomodations: | Double room |
Single room |
| Conference Fee |  | |
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= $ ____________ | |
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On Campus - Single Room $50 per day X _____ days |
= $ ____________ | |
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On Campus - Double Room $45 per day X _____ days |
= $ ____________ |
| Please mail registration form and payment to: | Alexander von Humboldt 2001 Department of Modern Languages Humboldt State University Arcata. CA 95521 USA |
| Off-Campus Lodging Information: | Make U.S. check or international money order payable to "Humboldt State University." |
| Pre-registration only (money not required with registration form) |
Please see enclosed handout. |
Please fill out the top porton of the "Registration Form" and acknowledge the following statement:
I, _____________________________________, will be paying my registration fees at the time of check in (on-site). I decline to take advantage of the On-Campus lodging package.