Radisson Hotel New Orleans
Name ________________________________
(PRINT NAME IN BLOCK LETTERS)
Address ______________________________
______________________________
______________________________
E-Mail Address ________________________
Arrival Date and time ______________
Departure Date ___________________
Single Room ($119 plus tax) __________
Double Room ($119 plus tax)__________
Sharing room with ____________________
Special requests: ___________________________________
MasterCard/Visa(cross out one)________________________
Diner's/American Express (cross out one)
_____________________
Expiration Date __________
Authorization
Signature ____________________________________