Eighth SIAM Conference on Discrete Mathematics

Dormitory Reservations
for The Johns Hopkins University

c/o SIAM - Discrete Mathematics Conference
3600 University City Science Center
Philadelphia, PA 19104-2688

There is a "Submit Dormitory Reservation" button at the bottom of this fill-in form. If you don't see the button, or if any of the check boxes or fill-in blanks do not appear correctly, your Web browsing software is not capable of handling this form. If that is the case, you should make your registration by one of the methods listed in Dormitory Information.

SIAM will send you confirmation of your electronic dormitory reservation within 10 working days. If you do not receive confirmation, please contact tmp@siam.org or the SIAM Conference Department by telephone at (215) 382-9800, fax: 215-386-7999, by e-mail at meetings@siam.org.

Dormitory rooms are being held for our exclusive use until Wednesday, May 15, 1996. After that date, reservations will depend on availability. To make a reservation, please fill-in this Dormitory Reservation Form and submit it to the SIAM Office. Upon receipt of your reservation, a confirmation will be sent to you.

If you are reserving a double room, you must supply the name of your roommate as SIAM will not randomly choose a roommate for you. Please be sure to fill out the entire form to ensure proper processing of your reservation.

Name, Address, and Phone Information

Name:
Address:
City: State: Zip:
Telephone: E-mail:
Fax:

Please make a reservation for:

$38.25/Single Suite
$30.50 per person/per night/Double Suite

Arrival Date: Departure Date:
Name of roommate:
I am a disabled participant and require appropriate accommodations: Yes No
Gender: Male Female

Please register me for the university meal plan (breakfast and lunch only) for the following days at $11.10 per day:

Monday, June 17
Tuesday, June 18
Wednesday, June 19
Thursday, June 20

I am registering for meal plan but staying OFF campus.
I am registering for meal plan and saying ON campus

Based on the above selections, my dormitory reservation should be dollars (Total # of Dorm nights x Amount per night = Total Dormitory Reservation).

Based on the above selections, my meal plan reservation should be dollars (Total # of Meal Days x $11.10 per day = Total Meal Plan Fee>

I choose to pay by: AMEX VISA Master Card
Credit Card Number: Expiration Date:

Now, to submit your dormitory reservation form to SIAM, press this button:


Back to Dormitory Information

MEM, 4/15/96