PACROFI VII CONFERENCE / June 1-4, 1998
REQUEST FOR CAMPUS HOUSING

Rooms will be available May 31 through June 6

PLEASE FILL OUT ALL INFORMATION COMPLETELY

NAME:_________________________________________________________________

MAILING ADDRESS:_____________________________________________________

________________________________________________________________________

TELEPHONE:(______)_________________FAX:(______)________________________

E-MAIL:_________________________  # OF NIGHTS :_________________________

ARRIVAL DATE (DAY & DATE):____________________________________________

DEPARTURE DATE (DAY & DATE):_________________________________________

Please check appropriate boxes:

(	) Double Room @ $15 U.S. per person per night
	   Preferred Room-mate:_________________________________________

(	) Single Room @ $21 U.S. per night

(	) Smoking		(	) Non-smoking
(	) I will have a car on campus and will need a parking permit. 
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Payment in full must be received with this application to reserve room. 
72 hour cancellation required for refund.

You may pay by check (in U. S.  Funds) made payable to: Board of Regents - UNLV
Mail check with this application to: UNLV Continuing Education / PACROFI, 
		Box 451019, Las Vegas, NV 89154-1019, USA.

Or you may pay with your Visa, MasterCard, American Express or Discover Card.

Card Type:___________________Cardholder Name:_____________________________
(Visa, MasterCard, American Express, Discover)			(Please Print)

Card Number #_______________________________________ Exp. Date:___________

Cardholder Signature:______________________________________________________

To Registration Form

To 2nd Circular