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ROOM SHARE PROGRAM FORM AMERICAN SOCIETY FOR LEGAL HISTORY 2007 ANNUAL MEETING OCTOBER 25-27,2007 TEMPE, ARIZONA If you want to share a room, you must complete this form. A valid credit card number is required for each occupant. Room charges will be billed directly to participants' credit cards. If you do not want to participate in the room-share program, you must make your own reservation directly with the Tempe Mission Palms Hotel--by phone 800-574- 8705 or 480-8941400; on the web by going to http://www.missionpalms.com. Click on "Reservations," select the dates of your arrival and departure, and in the box labeled "Group Code" enter 2T17T8. This form must be returned so that it is received by September 12, 2007 Participants will be notified of the name of roommate by September 19, along with contact information. Name:____________________________________Gender: Male___ Female________ Address:________________________________________________________________ City:_________________________________________________State:__________ Zip:__________ Institutional affiliation:_______________________________________________________________ Telephone: (home)_______________ (office)____________________ email:___________________ Nights room needed: Thurs, Oct. 25__________ Fri., Oct. 26_________ Sat. Oct. 27______________ Smoker: Yes_____No_______ Willing to share with smoker: Yes____ No________ Credit card information (REQUIRED) Name on card:____________________________________________________________________ Type of card:__________ Expiration: ___/_______ Number________________________________ Signature authorization: _____________________________________________________________ Comments: Return to: William P. LaPiana New York Law School 57 Worth St. New York, NY 10013 This form must be received at the above address by September 12, 2007