On-Campus Housing at Brown University

Thirteenth Conference on Uncertainty in Artificial Intelligence

July 31-August 3, 1997

Brown University Conference Services
Box 1864
Providence, RI 02912
Fax: (401) 863-7300

Housing Registration Form

(Please print or paste directly into email.)

Please print all information clearly.

NAME (Last, First, MI): ___________________________________

SEX: M___ F____

MAILING ADDRESS:

TELEPHONE NUMBER:____________________(home) ___________________(business)

ARRIVAL DATE: __________ TIME:________ DEPARTURE DATE: ___________

HOUSING:

All dormitories have semi-private bathrooms. Each room has at least one single bed, dresser, desk and chair. Each guest is provided with sheets, towel, pillow, pillowcase and, if needed, blanket. Linen is not changed during the conference.

NAME OF PERSON SHARING WITH YOU:__________________________

Please assign a roommate for me________

(If we are unable to assign you a roommate, you will be billed for a single room.

PAYMENT AUTHORIZATION

Your room reservation must be guaranteed by completing this credit card authorization form. One night's payment is not refundable if cancellation occurs after July 20, 1996.

Credit Card Type _________________________
(Master Card and VISA only)

Credit Card Number ______________________________

Expiration Date ________________

Name on Credit Card (Please print)_____________________________

___________________________________________
Signature of Authorization

Please return this registration form by June 20, 1997 to:

Brown University Conference Services
Box 1864
Providence, RI 02912

Other options:

Reservations received by June 20 will be confirmed. Any cancellations or changes should be made directly with Brown University Conference Services. Reservations for oncampus housing cannot be made by telephone.

Please indicate if you have any special disability requirements:

Please return this form by June 20, 1997