ICTAI 2001 Hotel Reservation FormGroup Name: IEEE Computer Society ICTAI 2001Please include one night's deposit with this form. |
Please mail or fax this form with check or credit card information to:
Crowne Plaza Suites Hotel Attn: Reservations Department 7800 Alpha Road Dallas, TX 75240 USA FAX +1-972-7018618Reservations must be made by Tuesday, October 16, 2001 at 5:00 p.m. Central time. Reservations made after this date are subject to availability of rooms and rates.
Please Print
Name:__________________________________________________________________
Last/Family First Middle Initial
Affiliation:___________________________________________________________
Address:_______________________________________________________________
City:___________State/Province:_________Zip:____________Country:_______
Phone:___________________________________Fax:__________________________
Please indicate the type of room you prefer:
( ) Single (one bed): US$109.00
( ) Double (two beds): US$119.00
( ) Smoking ( ) Non-Smoking
Arrival Date: _______________Time:______________ Flight:_____________________
Departure Date: ________________Time:______________ Flight:__________________
Deposit:
Credit Card: ( ) MasterCard ( ) Visa ( ) American Express
( ) Diners Club ( ) Discover
Credit Card Number: _______________________________Expiration Date:__________
(Please type or print clearly)
Signature:_____________________________________________ Date: _______________