FIRST NAME:  LAST NAME: 

I plan to attend the January conference:  Yes   No

I will attend the Friday noon luncheon:  Yes   No

I will attend the Friday evening dinner:  Yes   No

TRANSPORTATION:

I will be driving:  Yes   No (Mileage will be reimbursed at $.33 per mile.)

I will be flying:  Yes   No   Airline:  Flight #: 

Arrival:  Time:  Date:

Departure:  Time:    Date: 

I will need the use of a Concordia car:  Yes   No

I will need the car from to

Please utilize the shuttle service that the Courtyard Marriott provides to and from the airport.  If you need a car, we will leave it at the Courtyard Marriott.  Please leave your car at the Courtyard Marriott.

HOUSING:  Rooms have been reserved for you at the Courtyard Marriott, 1080 28th Ave. S., Moorhead, MN.

Please indicate your needs:

Thursday, Jan. 17     Saturday, Jan. 19

Friday, Jan. 18         Sunday, Jan. 20

All rooms are king, "non-smoking" unless you indicate otherwise.

REPLY:  Please fill out this form by December 18.