| University of Colorado at Boulder | |
| Summer Conference Housing Application | |
| Phone: (303) 492-5151, Fax: (303) 492-5959 | |
| E-mail: Lodging @ Housing.Colorado.Edu | |
| Please Type or Print |
Name of Conference: _______________________________________________________________
Participant's Name: _____________________________________________________ Sex: ______
(Last, First, Middle Initial)
Address: ________________________________________________________________________
City: ______________________________ State: ___________________ Zip: ______________
Country: ____________________
Telephone: Home: (____)_____________ Business: (____)_____________ Fax: (____)_____________
E-mail: ________________________________________________________________________
Arrival Date: __________________________ Departure Date: ____________________________
Please request one of the following: ____ Package #1 _____Package #2
Please request one of the following: _____ Single Room*
_____ Double Room (Roommate preference, if any)_____________
* There are a limited number of single rooms. If unavailable, assignment will be made to a double room with another conference participant.
Special Needs (Smoker/Nonsmoker, etc.) _________________________________________________
Complete if accompanied by spouse and/or family:
Spouse's Name: _______________________________ Arrival Date: ___________ Departure Date: _________
Children: Name: ____________ Age: _____ Sex: ____ Arrival Date: ____________ Departure Date: _________
Name: ____________ Age: _____ Sex: ____ Arrival Date: ____________ Departure Date: _________
Will a Rollaway Bed be Needed? _________________ Crib? _____________________
All charges are based on a package rate arranged for you by your conference.
Payment is due at check in. Cash, Traveler's Checks, Personal Checks, VISA, MasterCard, American Express, Diners Card, and Discovery Card will be accepted. Checks must be in U.S. Dollars drawn on a U.S. Bank.Do not send money in advance.
Please mail to: Office of Conference Services, University of Colorado, 500 30th Street, Boulder, CO 80310, USA. Or Fax to: (303) 492-5959.