Institute for Historical Review

Institute for Historical Review

IHR Conferences

Conference Registration Form

Institute for Historical Review

Please register me for the Thirteenth IHR Conference, Saturday, May 27 -- Monday, May 29th, 2000 (Memorial Day Weekend), Orange County, southern California

Name ..........................................................................................................................................................

Address ..........................................................................................................................................................

City State ZIP Country ...................................................................................................................................................

Telephone (..................) ...................................................................

Fax (.................) ...................................................................

E-mail ..........................................................................................................................................................

Number of conference reservations at $150 each ($195 after March 31, 2000) ..................................

(One application is good for all, but we must have the full name of each person covered by this application. Use a separate sheet if required.)

I will make my own arrangements for lodging. Y / N

I will need Single room with a large bed ($160 for 2 nights), Shared room with two beds ($80 per person for 2 nights,
Other .

I enclose my contribution of $ ......................... so that a deserving student may attend on scholarship.

Total $ ..........................................................................................................................................................

I am enclosing $ .............................. in cash check money order Visa MasterCard Amex

Card no. .............................................................................................. Exp. date ..................../........................

Signature of applicant ..................................................................................................................................

I attended a previous IHR conference (please give year) ..................................

I will require ground transportation from the airport to the conference site and back again. Y / N


Those who have not attended a previous IHR conference must also complete the following section.

My introduction to revisionism was through ...................................................................................................................................................................

My higher education includes the following:

...................................................................................................................................................................

The speaker who most interests me is:

...................................................................................................................................................................

I am a subscriber to The Journal of Historical Review yes no. (If yes, for how long?) ................................

Which attendees if any can vouch for you? Y / N

Which one(s): ............................................................................................................................................

If none, please provide at least two personal references with daytime phone numbers:

.....................................................................................................................................................................

I am a student requesting a scholarship. I am currently attending at

.....................................................................................................................................................................

where I am studying/majoring in

.....................................................................................................................................................................

This scholarship is important to me because:

.....................................................................................................................................................................

Send to: Institute for Historical Review
PO Box 2739 -- Newport Beach, CA 92659 -- USA -- Fax: (949) 631-0981
For more information: (949) 631-1490 or http://www.ihr.org/