If you are a conference registrant, please fill out this transportation form. While filling out this form is not required, we are encouraging all participants who can to help coordinate transport. Thank you. [Updated 4 July]

Because the event is only a few days away please e-mail the completed form to: creativerevolution@mindfreedom.org  If you absolutely cannot e-mail, then please print out this Travel Form by clicking on the’printer’ icon to the upper right and then fax to 541-345-3737.

Wisdom House Transportation Form for Creative Revolution 12 to 15 July 2007

Name _____________________________________________      I am registered for the conference __________

City___________ State/Province_____________ Country ______________

Phone number(s) where you can be reached:

Cell phone number you will have while traveling, if any: ___________________________

Other phone numbers: (day) __________________________ (evening) ________________________

Email: ______________________________

Please check all that apply:

I may be able to offer transport assistance because:

________ I will bring my vehicle or rental and I may be able to offer a ride for ____ other persons.

________ I would like to volunteer on the Creative Revolution Transport Team by DRIVING.

________ I would like to volunteer on the Creative Revolution Transport Team by COORDINATING.

I need transport assistance from or to:

    ________ Hartford Bradley Intl. Airport Airport

    ________ Hartford Amtrak Station

    ________ Waterbury MetroNorth Station

    ________ Other (please specify):

If you checked that you need transport assistance, please provide us with any details of your travel plans:

On 12 July 2007 I need to share ground transport to Wisdom House:

Departing from where (originating city)? __________________________ Flight/Train/Bus Number ________________

Estimated arrival time for your flight or train, etc.: _________________________

On 15 July 2007 I would like to share ground transport from Wisdom House:

Departing to where (final destination)? __________________________ Flight/Train/Bus Number ________________

Estimated departure time for your flight or train, etc.: _________________________

The above details are ____ all confirmed ____ not yet all confirmed.

Please contact the MindFreedom office immediately with any significant change. MindFreedom cannot guarantee help with your transport but we will do our best. Your understsanding is appreciated. Thank you.

Please feel free to add any other relevant details about your travel plans.

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