MPHA 2019 Annual Conference Roommate Request Form
We're excited that you'll be joining us for the 2019 Minnesota Public Health Association's Annual Conference at Bunker Hills Activity Center in Andover, MN on April 11-12, 2019!

Please fill out the following form by March 31, 2019 and we'll connect you with a potential roommate for the conference.

First, the fine print: Roommate Request Disclaimer: In no event is MPHA liable for any direct, indirect, incidental, consequential, special, punitive, or any other monetary or other damages, fees, fines, penalties or liabilities relating to the use of this website. When using this form, information is transmitted over a medium that is beyond the control of MPHA. Therefore, MPHA assumes no liability for, or relating to the delay, failure, interruption or corruption of any data or other information transmitted in connection with the use of the Roommate Request form. *
What day will you check-in? *
What day will you check-out? *
What hotel are you interested in staying at? *
What is the gender of the individual you would be comfortable staying with? *
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service