--CHI '95 STUDENT VOLUNTEER APPLICATION FORM--
 
Name:                                   
                                          [  ] Male   [  ] Female
Address:
 
 
Daytime telephone (include international code):
Home telephone (include international code):
Fax (include international code):
E-mail address:

Have you served as a CHI Student Volunteer before?  
[  ]yes      [  ]no  If yes, indicate which year(s):

Do you have any special qualities or experience you think would be helpful 
to CHI' 95?

What languages do you speak well enough to assist with non-native English 
speakers?

Do you need housing at the conference?      [  ]yes     [  ]no

Name of School:
Student status as of May 1, 1995:    
[  ]undergraduate   [  ]master's student   [  ]doctoral student

You MUST attach a photocopy of BOTH sides of your student 
identification card to this application.

School Address:


--END OF STUDENT VOLUNTEER APPLICATION FORM--