Registration for Telluride Summer Research Center
2001
Name ____________________________________________________________________
Institution _________________________________________________________________
Address __________________________________________________________________
City _____________________State _____________________Zip Code________________
Country ________________________Email______________________________________
Phone Number _________________________________FAX ________________________
Participating in which Workshop(s): _____________________________________________
Dates in Telluride (Note, housing runs from Sunday to
Sunday):_________________________
Local Address (staff will
enter)_________________________________________________
Local Phone Number (staff will enter): 728-_______________________________________
| Registration Fees for 2001: |
1 Week: |
2 Weeks: |
3 Weeks: |
(circle one) |
|
$160 |
$200 |
$240 |
|
| Payment for Registration and Housing |
Housing Total: |
$_______________ |
| see Housing Form for lodging rates |
Registration Total: |
$_______________ |
| (Full payment is due at time of reservation) |
TOTAL DUE: |
$_______________ |
Enclosed is my Check for $_________ (preferred) OR please bill my
VISA or Mastercard (circle one) No._________________________Exp
Date___________
My university/group will send payment by _______________________
Return payment by March 23 to: Telluride Academy, Box
2255, Telluride CO 81435
Cancellation Policy: If you cancel your housing reservation more than 60 days in advance a
25% penalty will be assessed. If you cancel less than 60 days in advance NO refunds can be
given. The Telluride Academy will firmly enforce our cancellation policy. |