Name:

Institution:

Address 1:

Address 2:

Phone: Ext.

Email Address:

Arrival Date:

Departure Date:

Accomodations: Hilton Gardan Inn Other

Thursday Evening Reception at The Program of African Studies (Thursday, May 5): Yes No

Friday Group Lunch (Friday, May 6): Yes No

Friday Evening Open House and Dinner at the Panofsky Residence (Friday, May 6): Yes No

Saturday Afternoon Trip to CRL (Saturday, May 7): Yes No

I need a ride to CRL for the tour and a ride back to Evanston following the tour (Saturday, May 7): Yes No