
38th Allerton Institute, October 27-29, 1996
Registration Form
Print this form and return to the address below.
LIBRARIES, PEOPLE, AND CHANGE:
A RESEARCH FORUM ON DIGITAL LIBRARIES
Thirty-Eighth Allerton Institute
Allerton Park and Conference Center
Monticello, Illinois
October 27-29, 1996
________________________________________________________________________
Last Name First Name Middle Initial
Title/Position: ________________________________________________________
Institution: ___________________________________________________________
Address: _______________________________________________________________
________________________________________________________________________
City State Zip Country
Business Phone: ________________________ FAX: _________________________
E-mail address: ________________________________________________________
Homepage address: ______________________________________________________
How I would like my name to appear on conference name tag:
__________________________________________________________________
Will you be staying at Allerton Park on Sunday, October 27 and Monday,
October 28? (included in registration fee)
_____ Yes
_____ No. I am making my own arrangements for lodging elsewhere.
I understand I'm responsible for these expenses and that there
is no reduction of registration fee for offsite lodging.
For purposes of room assignment at Allerton, please indicate gender:
F___ M___
If you would like to share accommodations with a particular individual(s),
please specify:
________________________________________________________________________
Any special dietary/lodging needs: _____________________________________
When are you planning to leave the conference: _________________________
Registration Fee: $120
Registration form and payment must be received by SEPTEMBER 30, 1996.
Method of Payment: (We can not accept purchase orders.)
_____ Check enclosed (make payable to University of Illinois)
_____ Charge to credit card:
____Visa ____Mastercard
____Discover ____American Express
Credit card number; ______________________________________________
Expiration date: _________________________________________________
Signature: _______________________________________________________
Arrival/transportation:
_____ I will be arriving on Saturday, October 26. I would like the
conference staff to make arrangements with Corky's A-1 Limousine
Service for transportation from my Champaign-Urbana hotel to
Allerton Park on Sunday, October 27. I understand that I am
responsible for payment directly to Corky's at the time of service.
I am staying at ____________________________________________
(hotel)
[Pickup will probably be between 11 a.m. and noon.]
_____ I will be arriving on Saturday, October 26. I will make my own
transportation arrangements to Allerton Park on Sunday.
Sunday, October 27, Transportation from Champaign-Urbana to Allerton Park:
_____ I will be arriving on Sunday, October 27, and would like the
conference staff to arrange transportation from the airport to
Allerton Park through Corky's A-1 Limousine Service. I understand
that I am responsible for payment directly to Corky's at the time of
service.
Arrival time & flight # on Sunday: _________________________
_____ I will be arriving on Sunday, October 27. I will make my own
transportation arrangements to Allerton Park.
To register...
by phone (payment by credit card): 217-244-3274 or 800-982-0914
(ask for Kathy Painter)
by FAX (payment by credit card): 217-244-3302
by email (payment by credit card): send to painter@alexia.lis.uiuc.edu
[E-mail transmissions are not always secure and there is some
risk in sending credit card information through this medium.]
by mail (payment by check or credit card), send to:
Allerton Institute 1996
Graduate School of Library and Information Science
University of Illinois at Urbana-Champaign
501 E. Daniel Street
Champaign IL 61820-6211