<p> Department of Housing and Residence Life (HRL) 2017 Summer Conference Inquiry Form</p><p>Conference Name: Click here to enter text. Host Department: Click here to enter text. ☐UTRGV Department ☐ Non Profit (501) ☐ Private Have you stayed with us before? ☐Yes ☐No </p><p>Contact Name: Click here to enter text. Contact E-mail: Click here to enter text. Mailing Address: Click here to enter text. Contact Phone: Click here to enter text. </p><p>Which campus will host the conference? ☐Brownsville, Texas ☐Edinburg, Texas </p><p>Group/Conference Description: Click here to enter text.</p><p>Room Occupancy Arrival Date: Click here to enter text. Departure Date: Click here to enter text.</p><p>Total Number of nights: Click here to enter text. Number of Anticipated Participants (Adults plus Youths): Click here to enter text.</p><p>Number of Adults: Click here to enter text. Double Occupancy ☐ * Single Occupancy ☐ Overnight Adult Gender Breakdown: Male Click here to enter text. Female: Click here to enter text. Notes:Click here to enter text.</p><p>Number of Youth*: Click here to enter text. Double Occupancy ☐ * Single Occupancy ☐ Overnight Youth Gender Breakdown: Male Click here to enter text. Female: Click here to enter text. *Participants under 18 years of age are considered Youth and as minors need Adult supervision. Notes: Click here to enter text.</p><p>Preferred housing area(s)/building(s) requested (if any): Choose an item.</p><p>Does your group/conference require ADA accommodation? Yes☐ No ☐ Please describe special accommodations or other needs: Click here to enter text.</p><p>Will your group/conference need parking accommodations during your stay? No ☐ Yes☐ # of vehicles Click here to enter text. Notes: Click here to enter text.</p><p>Will your group/conference need meeting space during your stay? No ☐ Yes☐ Will your group/conference need Food services during your stay? No ☐ Yes☐ Will your group/conference need linen services during your stay? No ☐ Yes☐</p><p>Billing Information The Summer Conference Inquire Form is not a binding contract and does not guarantee rooms requested above. ☐ UTRGV Department Account Click here to enter text. Department Name: Click here to enter text. ☐ Non-University Account Billing Address: Click here to enter text.</p><p>Once this form is processed the Department of HRL will send a quote and contract for approval. * Room Type Occupancy may not be available. Casa Bella only offers single occupancy. </p><p>For additional Summer Conference Housing information contact the Department of Housing and Residence Life – Edinburg, Texas: University Center 305 Office: 956-665-3439 | Fax: 665-5055 | Email: [email protected] Brownsville, Texas: Casa Bella Office: 956-882-7191 | www.utrgv.edu/housing</p><p>Department Use Only – Inquire Received ______Approve_____ Deny ______</p>