this Return form to:
By email [e-mail] Fax [phone] Mail ADAM'S MARK ST. LOUIS (Attn. Reservation Dept.) FOURTH AND CHESTNUT ST. LOUIS, MO 63102
Reservations by phone: [phone] OR (800) 444ADAM (toll free in the U.S. only) PLEASE MAKE YOUR RESERVATION BEFORE APRIL 22, 2005.
ICSE 2005 Hotel Reservation Form The Adam's Mark Hotel
The Adam's Mark St. Louis is pleased to host The International Conference on Software Engineering. To ensure accurate reservations, please complete this reservation request and return it before April 22, 2005. Requests received after this date will be accepted based on room and rate availability. Reservation requests must be accompanied by a deposit equal to one night's room rate plus 14.866% tax. This deposit will be applied to the last night of the reservation. Room Type Preference Number of guests: ____________ Single [ ] Special Group Rate [ ] Concorde Level Room Special Requests (subject to availability) [ ] Rollaway bed ($15/night) in rooms with one bed [ ] Wheelchair accessible room [ ] Nonsmoking room Guest Details Name: _____________________________________ Address: ___________________________________ ____________________________________ City/State/Zip: ______________________________ Telephone: _________________________________ Arrival Date: _______________________________ Arrival Time: _______________________________ Departure Date: _____________________________ Additional Guests: ___________________________ [ ] King Bed [ ] Two Double Beds [ ] Crib charge) (no [ ] $134.00 [ ] $164.00 Double [ ] $144.00 [ ] $174.00 Triple [ ] $154.00 [ ] $184.00 Quadruple [ ] $164.00 [ ] $194.00
[ ] I have enclosed a check in the amount of one night's room rate plus 14.866% occupancy tax. [ ] Please guarantee one night's room rate plus 14.866% occupancy tax to the following credit card: [ ] MasterCard [ ] Visa [ ] American Express [ ] Discover [ ] Carte Blanche/Diners Club CARD NUMBER:_______________________________________ EXP. DATE:______________________
[ ] JCB
I UNDERSTAND THAT I AM LIABLE FOR ONE NIGHT'S ROOM RATE PLUS 14.866% OCCUPANCY TAX WHICH WILL BE COVERED BY MY DEPOSIT IN THE EVENT THAT I DO NOT ARRIVE, CANCEL LESS THAN 72 HOURS PRIOR TO ARRIVAL, OR DEPART EARLIER THAN SCHEDULED.
______________________________________ ___________________________________________ NAME OF CREDIT CARD HOLDER SIGNATURE OF CARD HOLDER
Check in time after 3:00p...