Section I.

Group Name:  
Contact Name:
Mailing Address:
City:      State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming        Zip:
Telephone Number:              Fax Number:

Section II.

Please explain the purpose of your conference group:

Total number of people in group:
Number of Males: Number of Females:  
Number of Families/Couples:
How many single rooms will be needed:
Please inform us of any special needs (physically challenged, registration, setup, etc.):

Will you need linens for each participant? Yes No

Arrival Date: mm/dd/yy                        Arrival Time: am pm
Early Arrival Date: mm/dd/yy              Number of early arrivals:
Departure Date: mm/dd/yy       Departure Time: am pm

The Housing and Residence Life Office represents University of Louisville. The Assistant Director for Services will make all arrangements
regarding space, service, and charges.
The University will provide a live-in Resident Director responsible for the operation of the facility in which the Group will reside.

I have read and understand the University of Louisville Conference Group Eligibility Guidelines.

Name: Date: mm/dd/yy