PRINTABLE REGISTRATION FORM --  BROWN U. SHAW CONFERENCE

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 Brown University.  Note that a late registration fee of $25 per person applies if registering after May 1, 2006. Questions about registration and other conference details should be directed to the Brown U. Conference Staff at 401-863-2225 or by email to conference_services@brown.edu.

 

 

 

 

#

 

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

 

 

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

 

 

3

Family Member or Guest Fee or  Brown U. Faculty & Staff Fee (subtract $25 if an ISS member)

$75 per person

 

 

4

Student Registration Fee for non-ISS members (Student ID Required)

$100 per person

 

 

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

 

 

A C C O M M O D A T I O N S:

6

Brown U. Student Dorm (singles only; semi-private bathroom).  Reservation will be made for you if you include the cost in the last column to the right.

$50 per room per night per person.  No tax.  Indicate below if you need a campus permit to park a car.

 

 

7

A hotel-style Inn at Brown U. (two double beds; private bathroom; continental breakfast). Reservation will not be made for you.  Call 401-863-7500 for a reservation.   24 rooms.   First come, first served.

$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

8

Biltmore Hotel in downtown Providence.  Reservation will not be made for you.  Call 800-294-7709 or 401-421-0700 to make a reservation,  or go online at www.providencebiltmore.com/reservations.asp.  25 rooms until May 1.  First come, first served. 

$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.

 

Pay Hotel

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.

 

-----------

10

Campus Parking Permit Needed?

$7 per day if not staying at The Inn.

Yes or No? (Circle one). 

# of days?

 

11

Optional: Ticket for Trinity Theatre Production of Cyrano de Bergerac  (June 9 at 8:00)

$35 per ticket

 

 

 

 

YOUR TOTAL COST:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

REGISTRATION FORM --  BROWN U. SHAW CONFERENCE

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):  Professor     Dr.     Ms.     Mr.

 

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____________________