The "Windy City" Symposium -- Payment Form

This form should be included with your check for for registration fees and/or Room and Board.

Please fill out this payment form, attach your check and mail to:

Professor Paul Musial, Director
re. The "Windy City" Symposium
Department of Mathematics Chicago State University
9501 South King Drive
Chicago, IL 60628-1598


Contact Information

Name:



Mailing Address:









Day Telephone:



Night Telephone:

Fax Number:

e-mail:

Registration Fees

Your registration includes the use of conference facilities, meals on campus, refreshments, a Thursday afternoon excursion to either a Cubs baseball game or a City River Cruise, and one ticket for the banquet on Friday evening. If you wish to purchase a ticket for your accompanying guest to attend the excursion on Thursday and/or the banquet on Friday, these tickets can be paid for now or when you arrive on campus.


Lodging and Meal Fees

An important restriction is that for insurance reasons, persons under the age of 18 may not stay in the dormitories.

Please note that there is no hospital on campus, nor are there any medical personnel on campus. If you have any medical condition that you would like to inform the conference director about, please email me at this address (Professor Paul Musial) or contact me upon arrival at the conference.

All prices are per person in a shared double room.

Please itemize your payment below:

  1. Registration Fee:

  2. Lodging for yourself:

  3. Lodging and/or Meals for guest:

  4. Additional Excursion Ticket:

  5. Additional Banquet Ticket:
                                                            Total Included:


Please contact Professor Musial directly at


Payment together with a copy of this form may be sent to:

Professor Paul Musial, Director
re. The "Windy City" Symposium
Department of Mathematics
Chicago State University
9501 South King Drive
Chicago, IL 60628-1598