The
Indian Ocean: Cradle of Globalization
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Cover Letter | Application (.pdf file)| Schedule (.pdf file) | Housing (.pdf file) | Resources | Course Modules | Discuss Indian Ocean |
Name (last, first, mi.):
_______________________________________
E-mail: _______________________________________
Home Address: ____________________________________________ Fax Number:
__________________________________
__________________________________________________________ Daytime Telephone
____________________________
__________________________________________________________ Evening
Telephone ____________________________
I am interested in residence hall accommodations to
arrive on: ________________ and depart
on: ___________________
Sansom Place West
And would like to apply for:
Single Room with a shared
bath ($145 per person per week) ______________
Private
Apartment with one or two beds ($250 per apartment per week) ______________
Private
bedroom in a shared double suite ($175 per person per week) ______________
List suitemate preferences, if any, under additional
(up to 3):
Resident
name:
______________________________________________
Additional:
______________________________________________
Additional: ______________________________________________
Additional:
______________________________________________
Method of Payment:
I
authorize Penn to charge my University of Pennsylvania Bursar account (currently
matriculated Penn students only).
My
check/money order made payable to the Trustees of the University of Pennsylvania
with my name and social security number printed on front, is attached.
I
authorize Penn to charge my credit card.
Visa MasterCard American Express
Card #__________________________ Exp.______
Name as it appears on card: ____________________________
Signature of card holder:
______________________________________
Please send photocopy of credit
card.
* Please return this
application and one weeks deposit by May 24, 2002 to:
University
of Pennsylvania
Conference
Services
222
Sansom Place East
3600
Chestnut Street
Philadelphia,
PA 19104-6183
For more information, contact
Christina Iliadis at ciliadis@pobox.upenn.edu
or (215) 573-8631