Great Lakes Bioinformatics Retreat Registration Form

5th Annual Great Lakes Bioinformatics Retreat Registration July 31 - August 1, 2006
Important: Please register by July 15. The meals included in the registration fee include dinner on July 31 and a full breakfast, lunch, and snacks on August 1.

Type of Registration (please choose one):
Student		$125	registration, lodging, and meals (private room)
		$75	registration, lodging, and meals (shared room -- fill out information below)
		I am:	Male Female
			I have a roommate. His/Her name is: Assign me a roommate

	If student, your PI or advisor:

Academic		$175	registrations and meals

Corporate		$200	registration and meals

Lodging
This year we will be handling room reservations for students only. We have reserved a block of rooms at the Marriott Courtyard Grand Rapids Downtown; please refer to GLB Retreat when making your reservations. Rates are $99 for single and double occupancy. This rate will be available until Monday, July 17th. After this date, the rate will be $139. Please contact the Marriott at 616-242-6000 to make your reservations. Courtyard Marriott Down Town Grand Rapids, Michigan.

Your Information and Affiliation:
Salutation
First Name:
Last Name:
Suffix
Email Address

Affiliation (University or Company):
Street Address 1:
Street Address 2:
City:
State or Province:
Zipcode:
Phone:

Buffet-Style Dinner on July 31st
Will you be attending the dinner on July 31st?	Yes No
Menu Pork chops - "Herb crusted and stuffed with our homemade sage stuffing, char-grilled and then roasted with fresh thyme and a tangy mustard sauce." Rainbow Trout - "Farm-raised filets roasted with pecans, citrus butter and finished with a fruit zest." Lasagna Mornay - "Tender pasta layered with asparagus, fresh mushrooms, Mozzarella and Ricotta cheeses and covered with a creamy Mornay sauce." Dessert - Chocolate dipped pineapple and strawberries, assorted mini dessert bars and mini cheesecakes.


All registrants will be sent an invoice via email. Please make checks payable to the "University of Michigan" and send them to the address below: ATTN: Debbie Johnson University of Michigan 3600 Green Court Suite 700 Ann Arbor, MI 48105-1570 If you are University of Michigan faculty or staff, a UM "shortcode" can be used for payment of your registration. Please email Debbie Johnson (dla@umich.edu) with the shortcode number and contact person responsible for the shortcode. Credit cards are not accepted. If you have any questions, please contact GLB-Retreat@umich.edu or call (734)-615-5914.