Institute for Historical Review

14th IHR Conference Registration Form

Please register me for the Fourteenth IHR Conference, Friday, June 21st through Sunday, June 23rd, 2002, Orange County, southern California.

Name ..........................................................................................................................................................................................

Address .......................................................................................................................................................................................

City State ZIP Country .............................................................................................................................................................

Telephone (..................) ................................................................ Fax (.................) ................................................................

E-mail ..........................................................................................................................................................................................

Signature of applicant .............................................................................................................................................................

Number of conference reservations at $195 each .................................. (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.)

Friday-only attendance at $80 each .............................

Saturday-only attendance at $80 each ............................. (no banquet)

Saturday-only attendance at $120 each ............................. (with banquet)

Sunday-only attendance at $80 each .............................

For the nights of June 21 and 22, I will need:

___ Single room for 2 nights with a large bed ($150.00),

___ Single room for 2 nights with two beds ($150.00),

___ Shared room for 2 nights with two beds ($75.00 per person),

___ Other ..................................................................................................................................................................................

___ I will make my own arrangements for lodging.

For the banquet dinner, I prefer:

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 ....................../......................

___ I attended a previous IHR conference (please give year) .........................................

___ I will require ground transportation from the airport to the conference site and back again.

Those who have not attended a previous IHR conference must also complete the following section.

My introduction to revisionism was through: ..............................................................................................................

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My higher education includes the following: ................................................................................................................

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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? ...................................................................................................................

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If none, please provide at least two personal references with daytime phone numbers: ....................................

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I am a student requesting a scholarship. I am currently attending at .....................................................................

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where I am studying/majoring in ...................................................................................................................................

This scholarship is important to me because: ...............................................................................................................

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