Hotel Room Sharing Form

SIAM will keep a list of attendees who wish to share a room with another attendee to reduce expenses. If you are interested in finding a roommate and would like to be placed on the rooming list, please forward complete contact information to meetings@siam.org (preferred) or fax it to the SIAM Conference Department at +1-215-386-7999. Be sure to mention that you want to be placed on the MS10 list. If information is incomplete, we cannot guarantee that your name will be included. SIAM will provide the listing electronically to all attendees on the list. It is the responsibility of the attendee to make the contacts and arrangements with other attendees on the list.

Name of Conference:
Full Name:
Address:
Phone:
Fax:
E-Mail:
Arrival Date:
Departure Date:
Smoker:
Yes No
Gender:
Male Female

Please submit this information to SIAM.

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