Reservation Form for

Hampton Inn & Suites Flagstaff
2400 S. Beulah Boulevard
 Tel: +1 928-913-0900 Fax: +1 928-913-0800

 

InSITE 2005
Informing Science + IT Education Conference
June 16th  – 19th 2005

sponsored by
Northern Arizona University

 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: $65/night for non-Friday and Saturday night stay, $75/night for weekend + TAX (about 11%)
[These discount conference rates are guaranteed only until
April 30, 2004]

 

NUMBER OF NIGHTS: _______ @ $65 per night =  _______________

NUMBER OF NIGHTS: ________@ $75 per night = ______________

(Suites are available at a higher rate.  Call or fax the hotel for details.)

  

Type of Room:

Two Beds r One Large Bed   r  Suite 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
Hampton Inn & Suites Flagstaff
by 30th April 2005
Fax number
+1 928-913-0800