Registration Form

10^th Encuentro UPR-MIT Tren Urbano Professional Development Program

December 18-21, 2003, San Juan, Puerto Rico

Name: _______________________________Title/Position: ______________________

Department/Organization: _________________________________________________

Address:________________________________________________________________

City: _______________________ State: ________________ Zip Code: _____________

Phone: (____) _________________ Fax:(_____) ________________________________

E-mail: _________________________________________________________________

Name of Guest/Spouse/Husband: ____________________________________________

Tren Urbano Group that you belonged to:_____________ Year: ____________________

In which capacity did you participate:

__ UPR Student                                   ___ MIT Student         

__ HTA Representative                        ___ Faculty Advisor

__ Tren Urbano Staff                            ___ Speaker

__ Siemens Transit Staff                       ___ Other: ________________________________

Arrival Date: _______________________ Departing Date: _______________________

Activities you plan to attend at the 10^th Encuentro:_______________________________

What are you currently doing?: ______________________________________________

________________________________________________________________________

If you need hotel reservations please remember to identify yourself as a participant of the 10^th Tren Urbano Encuentro with the Embassy Suites Hotel in Isla Verde in order to get the special discounted rate of $150.00 plus 11% tax.  Contact person Yeisa Figueroa, phone: (787)-791-0505.

Please e-mail or fax this form to:            Diana Rubio: drubio@trenurbano.dtop.gov.pr

                                                            Vivian Vazquez: vvazquez@trenurbano.dtop.gov.pr

Fax: 787-765-3885