2014 Louisiana Environmental Education Symposium
LODGING ASSISTANCE REQUEST Form
NAME
FIRST LAST
E-MAIL PHONE
SCHOOL / ORGANIZATION PARISH
SCHOOL/ORG ADDRESS
STREET / BOX CITY STATE ZIP
PHYSICAL HOME ADDRESS
STREET CITY STATE
I live miles from the Shreveport Convention Center, one-way.
You must include electronic proof of distance (MapQuest, etc.) from your home to the Shreveport Convention Center, located at 400 Caddo Street, Shreveport, LA.
Please complete all that apply:
I am a full-time classroom teacher (K-12).
I am a full-time educator but not a K-12 classroom teacher.
I am a full-time university student.
I plan to submit/have submitted a proposal to present at the 2014 EE Symposium.
I am the recipient of a 2012 or 2013 School Sustainability Grant or Sustainability Initiative Program Grant.
I attended the symposium in: ¨ 2010 ¨ 2011 ¨ 2012 ¨ 2013
I presented at the symposium in: ¨ 2010 ¨ 2011 ¨ 2012 ¨ 2013
I have previously received lodging assistance award(s). Year(s) received:
______I plan to room with , who is / is not also applying
for lodging assistance.
Signature of applicant
A limited number of lodging assistance awards are available so it is suggested that lodging assistance applications be submitted as soon as possible. Recipients must be registered for the conference and are still responsible for the basic conference registration fee.
Lodging assistance awards will pay for one-half of a double-occupancy room at the conference hotel (Shreveport Hilton) for Friday, February 21, 2014. The lodging assistance award cannot be applied to other hotels. It is the recipient’s responsibility to make their own hotel reservation prior to the Shreveport Hilton’s February 7th deadline. For Shreveport Hilton reservations, please call 1-800-HILTONS and use code “DWF” to receive the conference rate.
Send this signed and scanned form and electronic proof of distance to Venise Ortego via e-mail at or mail to:
Venise Ortego
Louisiana Department of Wildlife & Fisheries
5652 HWY 182
Opelousas, LA 70570
337-948-0255