Texas Geometry and Topology Conference Registration Form

Texas Geometry and Topology Conference
Registration

All conference participants are requested to register. This form should also be used to request support, accomodations (hotel room) and banquet preferences.
Please print this registration form, and complete and mail it to: Min Ru, Dept. of Math., Univ. of Houston, Houston, TX 77204

Personal Information:

Name:	Mr. < > Ms. < >
Position/Title:
Postal Address: line 1:
line 2:
line 3:
line 4:
E-mail address:

Lodging Information:

Arrival: Date:                                   Time:

Departure: Date:                                   Time:

Room Type: Smoking:                             Non-smoking:

Occupancy: Single:                                  Double:

Name of Roommate :
(if applicable)*

    *Supported graduated students are asked to share a double room with one other student. Supported participants must inform conference organizers of cancellation or modification of reservation by Noon on Friday, Feb. 21 to avoid liability for one night's room rate. Non-supported participants must provide the hotel (phone numbers will be included with confirmation information) with a personal credit card number to guarantee the room if arriving after 6 p.m. on Friday, Feb. 21.

Support:

Do you wish to apply for support for the conference? Yes: No:

Do you have grant support? Yes: No:

Please list any special needs you may have:

Banquet: There will be a Chinese banquet in the evening of Feb. 22 (Saturday). The cost is estimated to be $15-20 per person which will be collected at the Registration Desk during the Conference.

Will you be attending the banquet ? Yes:             No:

Besides yourself, how many guests
will you bring to the banquet?    0     1     2     3     4     5

Do you prefer a vegetarian menu? Yes:             No:

Arrival:	Date: Time:
Departure:	Date: Time:
Room Type:	Smoking: Non-smoking:
Occupancy:	Single: Double:
Name of Roommate : (if applicable)*

Do you wish to apply for support for the conference?	Yes: No:
Do you have grant support?	Yes: No:

Will you be attending the banquet ?	Yes: No:
Besides yourself, how many guests will you bring to the banquet?	0 1 2 3 4 5
Do you prefer a vegetarian menu?	Yes: No: