General Information

Travel Information

 

 


WORKSHOP REGISTRATION
         Participant Information
Please do not fill out this form using all Caps (Use Title Case)

Title
First Name
* required
Middle Initial
Last Name
 *
Sex
 *
Affiliation/Organization
*
Affiliation type
 *
Department
 *
Street
 *
City
 *
State
Zip Code
-  
Country
 (Other than USA)
Foreign Postal Code
Foreign Phone
(include Country code)
Phone
 - - Ext.
Fax
Email
 *
Country of Citizenship
 *
Permanent US Resident?
Position
 * Media Guidelines

Lab Head [Last Name only]

 *
(15 characters max)
Meeting Title




Program Position
Organizer Invited Speaker Ses Chair
Housing Information

IMPORTANT: Please read the following housing guidelines:

  • Roommate requests for students will be honored where possible; due to space limitations, participants may be housed at outside hotels with another meeting participant.  Shuttle service will be provided for registrants whose housing assignments are made by CSHL. Check-in time is 3:00 PM.
  • Accommodations are preferentially reserved for meetings participants'
  • Additional day(s): $175 fee for food/housing
  • If you choose to make your own lodging arrangements, check here for local hotels. You may be responsible for your own transportation to and from the laboratory.
Require Housing
Roommates Last Name 
(if any)
max 13 characters  
Additional nights:

(You MUST include slashes to seperate month, day and year when entering dates for additional housing. Please follow the examples below.)

Prior to meeting
 (mm/dd/yy)
  example: for February 5, 2005 please enter 02/05/05
Following meeting
 (mm/dd/yy)
  example: for February 11, 2005 please enter 02/11/05
Kosher Diet
Vegetarian Diet
Other Special Condition
Payment Information 

 
  *
  Add $175 to meeting cost for each day's accommodations if you are arriving early or departing late.
Enter total into box below:

TOTAL DUE
   US$ * [please do not use decimals or symbols such as $]
Payment Method
 *
Cardholder Name
Credit Card #
(No spaces please between #'s)
Expiration Date (mmyy) (example 0404)
Payment Authorized
US$
**DEPOSIT REQUIRED:   $200 for registration, food & housing, $100 for registration and food only.  
This deposit is deducted from the total amount due.
Please authorize payment of deposit or full amount with this registration.
Please be advised that we no longer accept Wire Transfers for payments
*Check #
*Clearly state the Attendee and Meeting names with check
 

Payment will be processed only once your registration has been accepted by the organizers.

Online Registrations will not be processed until a method of payment is indicated.

Checks payable to: Cold Spring Harbor Laboratory
     
 

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Cold Spring Harbor Laboratory
Meetings & Courses Program
PO Box 100, 1 Bungtown Road
Cold Spring Harbor, NY 11724-2213
Phone (516) 367-8346
Fax: (516) 367-8845

meetings@cshl.edu