LODGING REGISTRATION FORM
DET/CHE `97

 

Name: _________________________________________________________
Male / Female: (circle one)
Lodging & Meals:
(Lodging includes dinner, breakfast, lunch. Check in 3:30pm. Check out 1:00pm.)
 
[ ] $108 for double occupancy per day
[ ] $138 for single occupancy per day
    To Room With:____________________________________
[ ] Sunday, Nov. 30
[ ] Monday, Dec. 1
[ ] Tuesday, Dec. 2
[ ] Wednesday, Dec. 3
    Total nights _____ x Rate ($______ ) = $_____________
Do you require a wheelchair accessible room? ___________
Dietary preference or restriction: vegetarian, or other_________________
Additional Conference Dinner Guests _____ x $25 each = $____________
Lodging and MealsSub Total ______________
Conference & MembershipSub Total ______________
  TOTAL _______________
 
Make Your Check Payable to "DET/CHE"
 
Send only one check, with completed registration and lodging forms, to:
Bob Romanelli
Senior Editor
Instructional Resources
University of California Santa Barbara
Santa Barbara CA 93106-3200
(805) 893-8373 (Fax)