 |
Institute for Historical Review
|
 |
Conference Registration Form
Institute for Historical Review
Please register me for the Thirteenth IHR Conference, Saturday, May 27 -- Monday, May 29th, 2000 (Memorial Day Weekend), Orange County, southern California
Name ..........................................................................................................................................................
Address ..........................................................................................................................................................
City State ZIP Country ...................................................................................................................................................
Telephone (..................) ...................................................................
Fax (.................) ...................................................................
E-mail ..........................................................................................................................................................
Number of conference reservations at $150 each ($195 after March 31, 2000) ..................................
(One application is good for all, but we must have the full name of each person covered by this application. Use a separate sheet if required.)
I will make my own arrangements for lodging. Y / N
I will need Single room with a large bed ($160 for 2 nights), Shared room with two beds ($80 per person for 2 nights,
Other .
I enclose my contribution of $ ......................... so that a deserving student may attend on scholarship.
Total $ ..........................................................................................................................................................
I am enclosing $ .............................. in cash check money order Visa MasterCard Amex
Card no. .............................................................................................. Exp. date ..................../........................
Signature of applicant ..................................................................................................................................
I attended a previous IHR conference (please give year) ..................................
I will require ground transportation from the airport to the conference site and back again. Y / N
Those who have not attended a previous IHR conference must also complete the following section.
My introduction to revisionism was through ...................................................................................................................................................................
My higher education includes the following:
...................................................................................................................................................................
The speaker who most interests me is:
...................................................................................................................................................................
I am a subscriber to The Journal of Historical Review yes no. (If yes, for how long?) ................................
Which attendees if any can vouch for you? Y / N
Which one(s): ............................................................................................................................................
If none, please provide at least two personal references with daytime phone numbers:
.....................................................................................................................................................................
I am a student requesting a scholarship. I am currently attending at
.....................................................................................................................................................................
where I am studying/majoring in
.....................................................................................................................................................................
This scholarship is important to me because:
.....................................................................................................................................................................
Send to: Institute for Historical Review
PO Box 2739 -- Newport Beach, CA 92659 -- USA -- Fax: (949) 631-0981
For more information: (949) 631-1490 or https://ihr.org/
|