Payment worksheet for the
conference
“Banach spaces and their
applications in
Analysis”
Name……………………………………………………………
E-mail
address…………………………………………………
Date……………………………………………………………
Registration fee (please
check on the correct line) …………………..______
__ $75 -- Regular registration, if paid on or before April
1, 2006
__ $90 -- Regular registration, if
paid after
April 1, 2006
__ $50 -- Student registration, if paid on or before April
1, 2006
__ $70 -- Student registration, if paid after April 1, 2006
Banquet
Number of tickets ____ * $35
=
…………………………………..______
Residence Halls
housing (if
applicable) – payment deadline May 10, 2006.
Dates of your stay
(recommended 7 nights:
arrival Sunday, May 21, 2006, departure Sunday May 28, 2006)
Arrival ……………………………
Departure …………………………
Number of nights
____ * $35
(for single room) = …………………...______
Number of nights
____ * $28
(for double room) = …………………..______
If double room,
name
of preferred roommate……………………………….
or
your gender ……………………………………………..
Total fees
……………………………………………………………...._____
Make checks payable
to Miami University