Class of 1953: Reunion Registration Form - Alumni

Class of 1953: Reunion Registration FormRegister online at www.alumni.cornell.edu/reunion or return this completed form with payment by May 24, 2013 to:Cornell Class of 1953, Alumni Affairs, P.O. Box 6554, Ithaca, NY 14851-6554Visit our class website at classof53.alumni.cornell.edu2013For Reunion Information:Caroline Mulford Owens, Reunion Co-Chair, cmo62@cornell.eduT. Richard Halberstadt, Reunion Co-Chair, trh47@cornell.eduClassmate InformationFirst Maiden (if applicable) LastPlease print your name as you would like it to appear on your button; we encourage inclusion of maiden name.Street address City State Zip CodePreferred phone Mobile phone (used only during Reunion weekend) Vehicle license plate number (for Reunion weekend)College E-mail address Cornell Net ID (found on mailing label)Check here if this is a new address or phone number.Emergency Information: For use during the Reunion weekend. Must list someone NOT accompanying you to Ithaca.Emergency contact name Preferred phone RelationshipDuring Reunion, your picture may be taken by a University Photography staff member and possibly used for future Cornell-related media purposes. If you do notwant your image used, you are responsible for notifying the photographer at the time the photo is taken. University Photography will delete the image on thespot.I agree to have my name listed on the class and university website as attending Reunion. Yes NoThis is my_________Cornell Reunion! (first, second, etc.)If you or your guest have special medical or mobility needs, please contact Trudy Curtis at tc349@cornell.edu or (607) 254-7115.Guest InformationPlease print your name as you would like it to appear on your button.Guest If Cornellian: maiden name (if applicable), class, and college Cornell Net IDGuest If Cornellian: maiden name (if applicable), class, and college Cornell Net IDExpected Arrival Date/TimeNo check-ins before 11 am Thursday, please.ARRIVAL DAY: Thurs. Fri. Sat. Time: 9 a.m.–2 p.m. 2–5 p.m. 5–9 p.m. after 9 p.m.MealsFor special dietary needs, please specify.# of Kosher # of Gluten-Free # of Vegan # of VegetarianPlease choose your dinner entrée:Saturday: # of Salmon # of Beef Tenderloin # of Other

Class RegistrationPlease refer to the enclosed information for the various fee options and what is included in each option. Prices are per person.*Early Bird Fee (by 5/10) or Regular Fee (after 5/10)Adults:Full weekend (Thursday dinner–Sunday breakfast) # ________ @ $300.00 @ $320.00 = $ __________________Partial weekend (Friday breakfast–Sunday breakfast) # ________ @ $268.00 @ $285.00 = $ __________________Mini weekend (Saturday breakfast-Sunday breakfast) # ________ @ $182.00 @ $195.00 = $ __________________Optional:Friday All-Alumni Lunch Extravaganza # _________ @ $017.00 = $ _________________Class Photo (Friday) # _________ @ $025.00 = $ _________________Tours:Thursday, 2:30 p.m.: Laboratory of Ornithology (max. of 80 people) # _________ @ FREE = $ _________________FREEFriday, 10 a.m.: Cornell Library Rare Book & Manuscript collection (max. of 50 people) # _________ @ FREE = $ _________________FREESaturday, 2 p.m.: Behind the Scenes Tour of Big Red Athletics (max of 60 people) # _________ @ FREE = $ _________________FREE* Please note: Early Bird deadlines end at midnight, Eastern Daylight Time.TOTAL CLASS REGISTRATION FEE = $HousingThe university residence hall charge is $58/adult per night, or save $38 by staying all 3 nights at a total cost of $136/adult.The 1953 headquarters will be located in Mews Hall. (Residence halls are non-smoking.)I/We will be staying on campus. OR I/We will be staying elsewhere. Please indicate where: ___________________________________Total number of adults ____________________ × $136.00 for all 3 nights _ORTotal number of adults ____________________ × Total nights __________ × $58.00 per nightTOTAL HOUSING FEE = $= $ __________________= $ __________________If you have a mobility impairment that requires a special housing assignment (near entrance, first floor, etc.), please explain below.Special housing assignments can only be made if registration forms are postmarked by 5/24/13.Special housing need: ______________________________________________________________________________________________________The Class of 1953 has a limited number of rooms at two hotels for Reunion weekend: The Statler Hotel (800) 541-2501 and Best Western Inn (607) 272-6100.Please call direct for reservations, and remember, first come, first served!PaymentIf you are paying with a credit card, please consider using our secure online system to register.Subtotal for class registration (from above) = $__________________I have enclosed a check made payable to Cornell Class of 1953. Check #I am using my Visa / MasterCard / Discover / American Express (circle one).Subtotal for housing (from above)TOTAL AMOUNT FEE = $= $ __________________Credit Card Number ___________________________________________________________________ Expiration Date _________________________Name as it appears on your credit card _________________________________________________________________________________________Signature/Date ___________________________________________________________________________________________________________Receipt of your registration will be acknowledged. Until May 24, 2013, all registrations are fully refundable.Refunds will not be processed until after Reunion weekend.