• publications
• wmq

On-Campus Accommodations Registration Form

If you wish to stay on campus, please fill out this form and return it with full payment to:

Office of Residence Life and Summer Programs
ATTN: Joshua T. Cheney, Suffolk University
150 Tremont Street
Boston, MA 02111
FAX: (617) 305-2504

DO NOT SEND THIS FORM TO THE OMOHUNDRO INSTITUTE!

Suffolk University
Residence Life & Summer Programs

Suffolk University Omohundro
6/6/08–6/8/08

A block of rooms at the Suffolk University Residence Halls has been reserved for Suffolk University’s Omohundro Conference for the nights of Wednesday, June 4, 2008, through Monday, June 9, 2008. Suffolk University offers single and double accommodations. Each room includes bed and bath linens, local telephone service, and breakfast. The residence hall features twenty-four-hour security, air conditioning, a computer lab, twin-size beds, and semi-private bathrooms. Complete and return this form no later than Friday, May 9, 2008. Please contact the Office of Residence Life and Summer Programs for any early arrival or late departure requests. Please send one reservation request per room.

Last Name Required. First Name Required.
Email Email is required. Not a valid email address.
Gender Male Female
Home Address
City State Alaska Alabama Arkansas Arizona California Colorado Connecticut Distrct of Columbia Delaware Florida Georgia Hawaii Iowa Idaho Illnois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska Nevada New Hampshire New Jersey New Mexico New York Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming
Postal Code

Emergency Contact

Name Relationship
Primary Phone Secondary Phone Number
Housing Arrival Date Arrival Time
(Check-in begins at 3:00 p.m.)
Departure Date Departure Time
(Check-out ends at 11:00 a.m.)

Do you have any allergies and/or medical conditions or are you taking any medications of which we should be aware when making room assignments? If yes, please explain.

Packages

Please select a type of room.

Single Room (Price @ $75.00 per night) Double Room (Price @ $50.00 per person per night)
Number of guests
Your room rate per night
Guest name(s)
Number of nights A value is required. Must be a number. Must enter at least one nught. 6 night is the maximum allowed.
Total Amount Due
Payment Information

FULL payment is due in advance and must be returned with this form. Acceptable methods of payment include check (payable to Suffolk University), money order, American Express, Discover, MasterCard, and Visa. Please send one payment per room.

Check. Make checks payable to Suffolk University. Credit Card
Please select one American Express Discover MasterCard VISA
Card Number:
Expiration Date (month/year)) January February March April May June July August September October November December
Card holder’s name: Card holder’s signature: