CHI '95 Housing Reservation Form

To Register for Housing:

Print this Housing Form from your Web browser, fill it out, and mail or fax to

CHI '95 Housing Bureau
1555 California Street, Suite 300
Denver, CO 80202 4264 USA
Fax +1 303 892 1636.

Telephone reservations will NOT be accepted. If you are faxing, please do not mail a duplicate hard copy. This will result in multiple reservations. Make copies of this form if additional room reservations are needed.

Special Conference Rates:

The special conference rates are available ONLY through the Housing Bureau. Reservations will not be accepted directly by hotels.

Check-in Time:

Check-in at all conference hotels is 4:00 pm. However, the hotels will make every effort to accommodate earlier arrivals.

Reservation Confirmation:

The Housing Bureau will send an acknowledgment within 10 days after receiving your housing form. The hotel will then send a confirmation in the mail with specific deposit requirements and instructions for payment by check if you did not provide a credit card number.

Housing Reservation Deadline:

All reservations must be received by the Housing Bureau no later than April 6, 1995.

Changes and Cancellations:

Changes and cancellations for an existing reservation may be made by telephone before April 6, 1995, by calling the CHI '95 Housing Bureau at +1 303 892 1112. After April 6, 1995, you must call your hotel directly. Cancellations must be received a minimum of 10 days prior to arrival to receive a refund of your deposit.

Reservation Information

(Return by mail or fax by April 6, 1995.)

List your 1st, 2nd, 3rd, and 4th choices for hotel accommodations below:

1st: _________________________________________________

2nd: _________________________________________________

3rd: _________________________________________________

4th: _________________________________________________

Arrival date: ___________________________________________

Arrival time: ___________________________________________

Departure date: _________________________________________

Number of persons in room (circle one): 1 2 3 4

Number of beds requested (circle one): 1 2

Reservations for (your name): ______________________________________

Sharing with: ______________________________________________________

Anyone with special needs and requesting information about access, please specify:

______________________________________________________

Method of Payment:

____ Check
____ American Express
____ Visa
____ MasterCard

Card number: _____________________________________________________

Expiration date: _______________________________

Name as it appears on card: ______________________________________

Signature: _______________________________________________________

All reservations require a one-night room and 11.8% room tax deposit. I understand the hotel will charge my credit card for the deposit or I will send a check directly to the hotel upon receipt of the official hotel confirmation. I also understand that if I do not send a deposit or provide a credit card, my reservation will be cancelled. Do not send a check for your hotel deposit to the chi '95 housing bureau. Payment by check is to be sent directly to the hotel once you have received an official hotel confirmation.

Your mailing address: ______________________________________________

City: __________________________________________________

State/Province: _________________________________________

Country: ______________________________________________

Postal code: ___________________________________________

Send acknowledgement by (select one): ____ Mail ____ Fax

Your fax number (with country and area code):

______________________________________________________

Your daytime phone number (with country and area code):

______________________________________________________

CHI '95 Web Housing Form (w9501b)