Roommate Matching Service

In an effort to reduce the cost of the 2006 EMS meeting, EMS is again providing a roommate matching service. If you are interested in sharing room costs, please submit this completed form.

Matched roommates will be contacted and they will then have to make the appropriate reservation at the hotel's Web site. 

Please note that this is only a matching service. Matched roommates will still be responsible for making their own hotel reservations!

Fields in Red are required.

Last Name	First Name	Middle Name
Address
City	State/Province	Zip/Postal Code
Daytime Phone Number	Fax	e-mail
	Male Female
Age	Gender
Yes No	Yes No
Smoker	Share with a Smoker?
14-September-2006 15-September-2006 16-September-2006 17-September-2006 18-September-2006	17-September-2006 18-September-2006 19-September-2006 20-September-2006 21-September-2006	1 2 3 4 5 6
Arrival Date	Departure Date	Number of Nights a room is needed?
If you already have a preferred roommate, please provide name and contact information:
Last Name	First Name	Middle Name
Address
City	State/Province	Zip/Postal Code
Daytime Phone Number	Fax	e-mail

   

Complete this form and submit it. Please note that information marked in red* above is required before the computer will accept your submission. Refer any questions about the EMS Roommate - Matching Service to: paul_white@hc-sc.gc.ca. Refer any technical questions about this form to The EMS Webmaster.

EMS Contact Information:
1821 Michael Faraday Drive, Suite 300, Reston, VA 20190
Phone: (703)438-8220    FAX: (703)438-3113
EMS E-Mail:

Last Modified: January 11, 2007