Reservation
Form for
Embassy
Suites Hotel Flagstaff
(a Hilton property, up-scale suites)
706 South
Milton Road, Flagstaff, AZ 86001
Tel: 1-928-774-4333 Fax: 1-928-774-0216
Conference organized by the Informing Science
Institute
Eli Cohen and Elizabeth Boyd, Organizers@InSITE.nu
NAME of Delegate:_____________________________________________________________
ADDRESS:______________________________________________________________________
______________________________________________________________________________
Country
__________________________________________ POSTAL CODE: ________________
TELEPHONE: _______________________ FAX:___________________________
EMAIL: ___________________________________________________________
Names of others sharing room (if any) ________________________________________________
DATE of
ARRIVAL: _____________ DATE of DEPARTURE: ________________
Room Rate:
$119/night for all
nights + TAX (about 11%) Two beds plus sofa bed sleeps up to five.
[These
discount conference rates are guaranteed only until
May 16
NUMBER OF NIGHTS: ________________ @ $119 per night = _______________
Two Double Beds r One King Size Bed r
Payment
details:
(Please circle) Money
order Credit Card
CREDIT CARD NUMBER:
____________________________________________
Expiration Date of Card (MM/YY) ______ Name of card holder ________________________
_____________________________________________________________________________
Signature of card holder Date
Should I need to change my
plans, I will notify the
hotel the day before I am scheduled to arrive. Otherwise the hotel will hold my
room for my arrival and charge my credit card for that night.
Please fax
completed form to
Embassy Suites Hotel Flagstaff
by 16th May 2005
Fax number +1-928-774-0216