PIELC 2017 Housing Request
We will use the following information to match you with a volunteer host. Please include as much information as possible so we can ensure you have a great stay in Eugene!
Last Name
Your answer
First Name
Your answer
Phone#
Your answer
Email Address
Your answer
Arrival Date
MM
/
DD
/
YYYY
Departure Date
MM
/
DD
/
YYYY
Organization
Your answer
Are you traveling with any other attendees?
Your answer
If yes, and if you would like to be placed together, please list names
Your answer
Acceptable Sleeping Arrangements
Are you able to bring sleeping bag or pillow?
How will you be traveling around Eugene?
Pets OK?
Any Food Allergies?
Your answer
Any other special requests?
Your answer
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