Shakespeare Conference Registration

First Name
(As it should appear on nametag.)
Last Name
Gender Male   Female 
Home Address
City, State/Prov., Zip

School Name
School Address
City, State/Prov., Zip

Home Phone
School Phone
Fax
Email Address

Would you like to receive future
correspondence via email?		 Yes    No 
Housing Request Dorm Housing   Hotel Information 
All accommodations are single-room unless otherwise indicated by both participants writing in the name of their desired roommate. Roommates must be of the same gender.
Roommate's name
(if applicable)
Payment Enclosed

US $1,000 Check payable to Phillips Exeter Academy Check here if funded by The Stranahan Foundation

Type in fields, print and mail completed form with payment to:
Shakespeare Conference, Phillips Exeter Academy, 20 Main Street, Exeter, NH 03833-2460