Solicitud en ingles

Registration Form
40th Annual HERA Conference
October 8 – 11, 2006

Our 40th Anniversary:
Celebrating Our Past and Creating Our Future
Statler Hotel, Cornell University
Ithaca, New YorkProgram and lodging information: www.housingeducators.org
Full Name: _______________________________________________ (First name for badge) ____________________________University/Organization: ____________________________________________________________

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Preferred Mailing Address:__________________________________________________________________________________
City: ________________________________ State/Province: ______________________ Zip/Postal Code: _________________
Country: _____________________________ Telephone:(______)__________________ Fax: (______)____________________
Email: ____________________________________________________________

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CONFERENCE FEES
1. Registration Fees (All fees listed in U.S. Funds.) Includesreception, 3 lunches, breaks, banquet, and proceedings.
POSTMARKED & PAID
PLEASE CHECK APPROPRIATE REGISTRAION FEE: BEFORE/ON SEPTEMBER 8 AFTER SEPTEMBER 8
HERA Member  $250  $280
Nonmember(includes new membership discount)  $275  $305
Nonmember  $260  $280
Student  $150  $180
$ ____________
If you received a scholarship, check  Do not pay a registration fee. Stillcomplete this registration form.

2. Indicate tour interest:

 ___ Wagner Vineyards: tour of winery and brewery (includes wine tasting) # ____ x $25 = $ ____________

3. GuestLunches Indicate number for each day: ___Mon ___Tues ___Wed: total number x $20 = $ ____________
Print full name of guest(s):

4. Guest Banquet (Monday) Indicate numberof guests: ___ total number x $35 = $ ____________
Print full name of guest(s):

5. Payment of 2006 HERA Membership Dues:
Active/Affiliate $85 Student...