2007 PEER Annual Meeting Registration Form

HOTEL REGISTRATION DEADLINE IS JAN. 12, 2007--RESERVATIONS REQUESTED AFTER THIS DATE CANNOT BE GUARANTEED

First Name
Last Name
Title
Affiliation
Address Line 1
Address Line 2
City
State or Province
Postal Code
Country
Phone
Alternate Phone
Fax
Email Address
Participant Category:	Faculty member Graduate student researcher Undergraduate student intern Business/industry partner Staff Other
Primary PEER Thrust Area Affiliation/Interest: Please choose the affiliation that most closely describes your interest in the meeting.	TA I - Building Systems TA II - Bridge and Transportation Systems TA III - Lifeline Systems TA IV - Simulation and Information Technologies
Yes, I plan to attend:	Luncheon, Jan. 19, 2007 Banquet, Jan. 19, 2007 Luncheon, Jan. 20, 2007
I will need hotel accommodations for these nights:	Thurs. night, Jan. 18, 2007 Friday night, Jan. 19, 2007
Note: PEER will only cover the cost of room and tax for faculty, students, BIPs, and other project personnel. Hotel Nikko will request a credit card, or a refundable cash deposit, to cover any incidental room charges.
Students: PEER will assign two students per room, unless the student requests an individual room (below).
Please indicate your roommate preference
I am a student and would like to request a single room for myself and agree to reimburse PEER for half of the room and tax charge for Thurs. and Friday nights at the Hotel Nikko. I understand this will amount to $99.50 plus taxes, per night.
Please initial here
NEEDS AND PREFERENCES If you have specific dietary needs or preferences (e.g. food allergies, vegetarian meals) or accessibility requirements (e.g. mobility assistance), describe them here and we will do our best to accommodate you
Note: The registration will be completed at the Earthquake Engineering Research Center website.
Send comments or questions to PEER.