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UCSA Student Lobby Conference
Group Registration Form

Must be filled out by delegation leaders only

Please use organizational contact information if available.
Name:
Association:
Organization(s):
Position(s)/Title(s):
Phone:		Fax:
Email:
Address

City:

State:

Zip:

Special Needs Deadline February 8, 2008

Please list the number of people from your delegation with each of the following needs:
We will do our best to accommodate but cannot guarantee special needs after the registration deadline.

Dietary Needs:

Vegan

Vegetarian

Diabetic

Food Allergies (Please Specify):

Wheelchair Access		Large Print Materials
Childcare		Sign Interpreter

Other (please Specify):

Pre-Registration Deadline: February 8, 2008 Registration must be received by the UCSA office by the deadline to qualify for the standard registration rate. Payment must be received no later than the first day of the conference, or your will be charged the late rate. You will be billed for all pre-registered delegates. Registration Rates: Delegation of 1-4 students: $125 per student Delegation of 5-9 students: $120 per student Delegation of 10-24 students: $110 per student Delegation of 25-39: $100 per student Delegation of 40-49: $90 per student Delegation of 50+: $75 per student Late or On-Site Registration Rate: $125 per students Cash, check or Purchase Order Make payable to: UC Student Association No refunds Hotel Reservation Deadline: February 8, 2008 Radisson Hotel Sacramento 500 Leisure Lane Sacramento CA 95815 Reservations: (800) 333-3333 UC Student Assocation Rates: Single or Double - $95/night Triple - $105/night Quad - $115/night Associations must call the Radisson Hotel in Sacramento and state that you are making hotel reservations for UCSAs SLC to get the UCSA hotel rate. Those reserving rooms must provide a credit card to guarantee reservation by February 8, 2008.

Diversity UCSA encourages delegation leaders to recruit a diverse delegation to UCSA Student of Color Conference.

Please list ALL delegates, including yourself, separated by commas
Please list ALL of the email addresses of ALL delegates, including yourself, separated by commas
Total students registered:
Check in Date:		Check out Date:
Total rooms reserved:		Name on reservation:

UCSA Student Lobby Conference Group Registration Form

Special Needs Deadline February 8, 2008

Pre-Registration Deadline: February 8, 2008

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UCSA Student Lobby Conference
Group Registration Form