Month: August
Day:
Year: 1996
Time:
List all room Occupants
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Credit Information
Please confirm your reservation by credit card (note: electronic transmission
is not secure and is at your own risk!).
Card Type:
Visa
MasterCard
Card Number: -
Expiration Date: Month, Year
Unguaranteed reservations will not be held for late arrival
Personal details
Name:
Institution:
Address (Line 1):
Address (Line 2):
City:
State:
Zip/Postal Code:
Country:
Email Address:
Phone Number:
Fax Number:
Special Needs
Please list any special needs the hotel should be aware of.
If you don't want to send your housing reservation electronically, please return it to:
DPF96, School of Physics and Astronomy, University of Minnesota,
116 Church St. S.E., Minneapolis, MN 55455, U.S.A.
Email: dpf96@mnhep1.hep.umn.edu
Phone: (612) 624-7886, fax: (612) 624-4578
Sponsored by the University of Minnesota, the University of Wisconsin and the U.S. Department of Energy.
Comments/questions to: allan@mnhep1.hep.umn.edu (web), or dpf96@mnhep1.hep.umn.edu (DPF)
The URL of this page is http://www.hep.umn.edu/dpf96/housform.html
Last Updated: 13 July 1996