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Personal Information
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Name (to appear on badge)
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Institition (to appear on badge)
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Telephone Number
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() - Ext.
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Email
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Re-enter Email
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Mailing Address
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Registration Fee
Standard ($25) / Student ($10)
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Standard Student
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Contributed Talk
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Do you wish to contribute a 15 minute talk?
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Yes No
If "Yes", either include a title and abstract below or mail them
directly to Gerard Venema at venema@calvin.edu
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Title
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Funding Request
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Indicate if support
is requested
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Requested Not Requested
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If requesting support, please
itemize reqested expenses
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If requesting support, please
indicate other sourcces of
support (such as grants)
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Lodging
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Dormitory
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Click here if requesting a dormitory room
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Indicate the type of room you are requesting. You may
request a particular roommate or a suitemate. If you do not request a particular suitemate,
one will be assigned. See the Housing Page for a description of the dormitory rooms.
The nights you will be staying will be computed from your arrival/departure dates you indicate below.
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Single Room (private bath) ($33/night)
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Single Room (shared bath) ($18/night)
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Indicate suitemate
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Double Room (private bath) ($18/night)
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One person Two people
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Indicate roommate
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Double Room (shared bath) ($13/night)
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One person Two people
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Indicate roommate
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Indicate suitemates
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Family Suite ($40/night)
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Hotel
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Click here if you have made
arrangements to stay in a hotel.
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Indicate the name of the hotel in which
you have made reservations
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Saturday Evening Dinner
(Thursday evening picnic is included with registration.)
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Saturday Evening Meal ($25)
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Number of Dinner Tickets
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Miscellaneous Information
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Arrival Date
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Departure Date
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Anything else we
should know?
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