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Interview Room Request Form

AJS 45th Annual Conference
December 15-17, 2013 • Boston, Massachusetts
Sheraton Boston

Print and mail with your check to:
Association for Jewish Studies
15 West 16th St
New York, NY 10011
Attn.: Interview Room Request

Name ____________________________________________________________

Position __________________Institution________________________________

Mailing Address_____________________________________________________

Street Apt./P.O. Box_________________________________________________

City State/Province Zip/Postal Code____________________________________

Country __________________________ E-mail __________________________

Telephone ________________________ Fax_____________________________

Name and email address of person in charge
of interviews on-site, if different from above: ______________________________


 
  I require ___ 4-hour time slots @$60.00 USD per 4-hour block and enclose a total of $______.  
     
 

In order of preference I request the following dates and times:

Sunday, 12/15 9:00 am - 1:00 pm _________
Sunday, 12/15 2:00 pm - 6:00 pm _________
Monday, 12/16 9:00 am - 1:00 pm _________
Monday, 12/16 2:00 pm - 6:00 pm _________
Tuesday, 12/17 9:00 am - 1:00 pm _________
Tuesday, 12/17 2:00 pm - 6:00 pm _________

Signed: ________________________________