MANAGING CHANGE            PHILADELPHIA            REGISTRATION FORM

Before 15 February 2001
[ ]    ICOMOS MEMBER - US$180
[ ]    Non-ICOMOS MEMBER - US$250
[ ]    US/ICOMOS Student (with proof) - US$60
[ ]    Non-US/ICOMOS Student (with proof) - US$100
[ ]    Student attending US/ICOMOS Institutional Member College/University - US$60

After 15 February 2001
[ ]    ICOMOS MEMBER - US$220
[ ]    Non-ICOMOS MEMBER - US$290
[ ]    US/ICOMOS Student (with proof) - US$80
[ ]    Non-US/ICOMOS Student (with proof) - US$120
[ ]    Student attending US/ICOMOS Institutional Member College/University - US$80

Name (First, Middle and Last):    _________________________________________________________________________

Institutional Affiliation:                _________________________________________________________________________

National Committee (if applicable):    _________________________________________________________________________

Mailing Address:    _________________________________________________________________________
_________________________________________________________________________

Tel:    ______________    Fax:    ______________    E-mail:    _______________

Note:    Payment is due in US Dollars by check or money order.  Registration fee includes all papers and Symposium documents, one study tour, Symposium reception, and snacks and refreshments at breaks between sessions.

US/ICOMOS has reserved a block of rooms at the Latham Hotel (135 South 17th Street, Philadelphia, PA 19103; tel: 1-215-563-7474; fax: 1-215-568-0110).  The Latham is located at the corner of 17th and Walnut streets and is approximately a 15 minute walk from the University of Pennsylvania campus.  Please reserve by March 5, 2001 and refer to the US/ICOMOS group to obtain the discounted room rate of $118 (+ 14% city/state taxes).