PRINTABLE REGISTRATION
FORM --
June 8-11, 2006
The registration
fee includes all sessions, a welcome reception, continental breakfasts at
Salomon Ctr. on Friday and Saturday, refreshments, shuttle service to Trinity
Theatre on Friday night, and buffet banquet & theater performances at the
Faculty Club on Saturday night. Please print out the two pages of the
registration form below, fill in both pages, and mail to Brown University Shaw
Conference, 42 Charlesfield St., Box T, Providence, RI 02912 or fax form to
(401) 863-3955. Checks (cheques) in
U.S. dollars should be made out to
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# |
TYPE OF FEE First, select from rows 1 through 5. Then select from rows 6 through 9. Items 10 and 11 are optional. Please circle the #s of items selected. |
FEE IN U.S. DOLLARS Add $25 per person if registering after May 1, 2006. |
# Per Item |
Your Total Cost Per Item |
|
|
1 |
Standard Registration Fee |
$195 per person |
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2 |
Registration Fee for International
Shaw Society Members (You can join now
to get this discount and others. Go to
www.shawsociety.org and click on
"Membership Application") |
$150 per person |
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|
3 |
Family Member or Guest Fee or |
$75 per person |
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4 |
Student Registration Fee for non-ISS
members (Student ID Required) |
$100 per person |
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5 |
Student Registration Fee for ISS
members (You can join now to get this discount and
others. Go to www.shawsociety.org and click on
"Membership Application") |
$50 per person |
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A C C O M M O D A T I O N S: |
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6 |
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$50 per room per night per person. No tax.
Indicate below if you need a campus permit to park a car. |
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7 |
A hotel-style Inn at |
$110 per room per night, two people max. No tax. Parking free.
Indicate below if you need a campus permit to park a car. |
|
Pay Hotel |
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|
8 |
Biltmore Hotel in downtown |
$139 per room per night + tax. Conference rate
must be asked for. Parking
extra. Indicate below if you need a
campus permit to park a car. |
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Pay Hotel |
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9 |
I will commute or arrange other
accommodation. Circle #9 if choosing
this option. |
Indicate below if you need a campus
permit to park a car. |
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10 |
Campus
Parking Permit Needed? $7 per day
if not staying at The |
Yes or No? (Circle
one). |
# of days? |
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11 |
Optional: Ticket
for Trinity Theatre Production of Cyrano
de Bergerac (June 9 at 8:00) |
$35 per ticket |
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YOUR TOTAL COST: |
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REGISTRATION FORM --
Page 2
PLEASE NOTE:
1. Registration is not complete until fee
is paid in full. For security/privacy,
DO NOT email credit card information.
2. Registration fees will be refunded (less
a $35 handling charge) if written notice of cancellation is received on or
before May 8, 2005. No refunds can be
made after that date.
3. If you require a visa for travel to the
United States, please contact your local U.S. Embassy or Consulate for detailed
information on the requirements for obtaining a visa. Information is also available at http://usembassy.state.gov/.
Name
(s)___________________________________________________________________________
___________________________________________________________________________________
Title
(Circle One):
Address______________________________________________________________________________
City_______________________________________
State or Region ____________________________
Country:
______________________________________________Postal Code____________________
Telephones
(with country code): ________________________________________________________
Cell Phone #
(with country code):_______________________________________________________
FAX # (with
country code):_____________________________________________________________
Email Address
(essential):______________________________________________________________
Travel
Information:
Arrival
Date__________________________Time_______________ Departure Date_______________
Name &
Address of place you're staying if not conference accommodation:
_____________________________________________________________________________________
Name-badge
Information:
Please print
your name(s) as it should appear on name-badge(s):
_____________________________________________________________________________________
Please print
your affiliation(s) as it should appear on name-badge(s):
_____________________________________________________________________________________
PAYMENT INFORMATION:
Please total
your registration, housing fees, and optional costs from the form above and
enter that on the Amount Paid line below.
Then provide payment information:
Name of
Registrant Paying______________________________________________________________
Amount
Paid_________________________________________________________________________
Method of
Payment (Circle One): VISA MasterCard Check (US Funds Only)
Credit Card #________________________________Expiration
Date_______________________
Name on
Card________________________________________________________________________
Signature____________________________________________________Date____________________