Adam's
Mark Hotel Conference
Type of Room No. of Rooms
Rates
Single (1 person) _____________
$94
Double (2 people) _____________
$94
The above rates are subject to applicable state and local taxes.
Date of Arrival____________________________________________________
Time of Arrival____________________________________________________
Date of Departure__________________________________________________
Check-in Time: 3 p.m. Check-out Time: 12 noon
Name ___________________________________________________________
Institution ________________________________________________________
Address _________________________________________________________
_____________________________________________________
Email ___________________________________________________________
Telephone No._____________________________________________________
Sharing Room with_________________________________________________
Special requests:___________________________________________________
_________________________________________________________________
Reservations requested after 18 September 2000 or after the
room block has been filled are subject to availability and may
not be available
MasterCard o Visa o
Credit Card# ______________________________________________________
Expir. Date__________________
o I authorize my account to be
charged.
Signature___________________