Symposium Campanum Registration (Printable)

Symposium Campanum Registration Form

Registration Fee (required) €100/$110
(includes four buffet luncheons, snacks, tea and coffee breaks)

Other charges (not required)
Lodging (includes 4 American breakfasts and 4 dinners) at the Villa Vergiliana
Shared room at the Villa Vergiliana €60/$65 per night
Dinner (no lodging) €20/$22

Checks paid in USD and addressed to “The Vergilian Society, Inc.” should be sent with completed registration form to:

Name ______________________________________________________
Affiliation____________________________________________________
Mailing address_______________________________________________________
Telephone_______________________________
Fax____________________________________
Email___________________________

Lodging Dates:
Wed. October 4____ Thurs. October 5____ Fri. October 6_____ Sat. October 7____
Other Nights __________

Total Number of Nights Lodging: ________
Total Cost of Lodging  _____________
Registration Fee _____________
Total Amount Enclosed _____________
Balance Due _____________

Submitters, please include the following information.

Special equipment needed (e.g. slide, digital or overhead projector)
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________