Anita Borg Scholarship Retreat Australia

 

Travel Request Registration

This travel request registration form needs to be completed no later than TUESDAY, OCTOBER 10, 2006, 5:00 PM EDT.

 

Required Field

 

Contact Information

All fields under contact information are required.

First Name

 

Last Name

 

Mailing Address

 

City

 

Country

 

Postal Code

 

Telephone

 

Cell Phone

 

Email Address

 

Emergency Contact

Name

 

Relationship

 

Phone

 

Travel Request

  • GOOGLE will make your hotel reservation and arrange for your accommodations between October 26 arrival and October 28 departure at the Hilton Sydney.

  • YOU will need to be responsible for your own hotel incidentals - a credit card will be required if you anticipate ancillary expenses (such as telephone calls, movies, etc.).

Preferred Airport for Departure

Check here if you do not require travel or hotel accommodations and enter N/A in the field above. 

       Move forward to Event Information. 

Alternate Airport

Preferred Airline(s)

Airline Mileage Number(s)

Seating Preference

Please note, given the short notice of travel arrangements, we cannot guarantee seating preference.

Arrival(ignore if travel N/A)

 

Departure(ignore if travel N/A)

Other Arrival/Departure

Please note - you may request earlier arrival or later departure, however, you will be responsible for your own accommodations for extended stays. 

Click here if you would like us to check availability at the host hotel for the extended stay. The single room cost is $270 (Australian Dollars) per night.

Roommate Request

  If you don't have a preference or know another award winner, Google will assign a roommate.

Special Accommodations

Dietary Requests

T-Shirt Size Preference

 

 

Questions/Comments