VISITOR INFORMATION SHEET
 
Nuclear Physics with Effective Field Theory: 1999
INT99-15W
February 25 & February 26, 1999
 
Family name:  [                           ]  First name:  [                      ]
[ ] Professor    [ ] Research Associate       [ ] Graduate student
[ ] Other:    [             ]
 
Department: [                                       ]
Institute: [                                           ]
Address:[                                                             ]
Office Tel #: [               ] Home Tel #:  [                         ]
Fax #:  [               ] E-mail: [                             ]
 
*If different from above, where can we contact you prior to your arrival?
                       
                                                       
 
*If you are not a U.S. citizen, please state the following:
Country of Citizenship: [                  ]  Current visa: [                 ]
(Non-U.S. citizens must contact Linda Vilett at 206-685-3958,
vilett@phys.washington.edu.)
 
*Does a DOE or NSF grant support your research at your home institution?
  [ ]yes   [ ]no
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Expected dates of arrival and departure to and from Seattle:
Arrival:  [          ]   Departure:  [           ]
Flight #: [          ]   Flight #:   [           ]
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HOUSING INFORMATION: A block of rooms has been reserved at the University
Silver Cloud.  The address of the Silver Cloud is 5036 25th Avenue NE,
Seattle, WA 98105;  (206) 526-5200.  It is approximately 25 minutes walking
distance (or 15 minutes by bicycle) from the INT offices by way of the
Burke-Gilman Trail.  They also offer a shuttle service to campus.  The
newly remodeled University Village Shopping Mall is nearby. There is an
indoor pool and spa, fitness center, guest laundry, and free on-site
parking.  Each room has a small refrigerator and microwave.  Reservations
must be guaranteed with a credit card or deposit for the first night.
Continental breakfast included.
Special Room Rates: $74/night + 15.6% tax  Extra person charge:  $10
 
Hotel Info.: [ ]Single (1 person)
             [ ]Double (2 persons):  [ ]one bed   [ ]two beds
             [ ]Smoking   [ ]Non-smoking
Credit card # and expiration date to guarantee room:
             [                                                                             ]
**Please note the room will not be guaranteed/held without this information**
 
*Will you have a car for your use while in Seattle? [ ]yes  [ ]no
Comments:
 
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Please reply by January 1, 1999 by returning this form by mail or fax to:
Maria Francom
Institute for Nuclear Theory
Box 351550
University of Washington
Seattle, WA  98195-1550                            Fax: 206-685-3730