2015 TASA/TASB Convention

Housing Registration Request Form

1. Contact InformationIndividual filling out form

Main Contact Name *This question is required.

Main Contact Phone *This question is required.

Main Contact Email *This question is required. This question requires a valid email address.

Role *This question is required.

School District/Organization *This question is required.

Street Address *This question is required.

Apt/Suite/Office

City *This question is required.

State *This question is required.

Zip *This question is required.

2. Rooming List Information

First Name

Last Name

Arrival This question requires a valid date format of MM/DD/YYYY.

calendar

Departure This question requires a valid date format of MM/DD/YYYY.

calendar

If you require accessible accommodations or special aids, please fill those in here. Requests for accessible accommodations will be confirmed by the Hotel prior to arrival. All other requests will be forwarded to the Hotel but are based on availability upon arrival and cannot be guaranteed.