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Eastern Association of Colleges & Employers

U.S. Postal: EACE Housing • C/O CONNECTIONS • 820 Church Street • Decatur, Georgia 30030

Current Information:

Delegate Information:

Name: email:
Address:
City: State: Zip:
Phone (Home) Work:
Fax: Beds:

One    Two

GROUP Name:  

Smoking    Non-Smoking

Arrival Date: Departure Date:
Sharing Room with:
Questions / Comments:

Change To:
Name: email:
Address:
City: State: Zip:
Phone (Home) Work:
Fax: Beds:

One    Two

GROUP Name:  

Smoking    Non-Smoking

Arrival Date: Departure Date:
Sharing Room with:
Questions / Comments:
Credit Card Information:
 (must be complete if check or money order is not included)

Credit Card :
Cardholder Name :
Card Number :
Expiration Date :

 
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820 Church St., Decatur, GA 30030