TRAVEL RESERVATION FORM

NSF/ITO GRANTEE'S WORKSHOP
Arlington, Virginia
April 18-20, 1997

Download this form & E-Mail it today: averfurt@courtesyassoc.com

Anne Verfurth
Courtesy Associates
655 Fifteenth Street, N.W.
Washington, DC 20006

If you prefer, you may print the form and Fax it to her at (202) 347-6109

TRAVELER INFORMATION

 
Name:
Affiliation:
Address:
 
 
City State:
Country:
Work Phone
Home Phone:
Fax:
Email:


AIRLINE RESERVATIONS
Preferred Airline:
Frequent Flyer Number:
Seating Preference:
Departure Preferences:
Date:
Time:
Return Preferences:
Date:
Time:
Please Indicate any Special Restrictions and/or Requests:


HOTEL RESERVATIONS (please check all that apply):
Friday, April 18, 1997
Saturday, April 19, 1997
Sunday, April 20, 1997
Will you be attending the Friday evening get-together? YES: NO:

Which do you type of room do you prefer? Smoking: or  Non-Smoking:

Please Indicate any Special Preferences and/or Restrictions:


Any additional information you would like Courtesy Associates Travel to Know?



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