2001 International Ash Symposium -- Printable Hyatt Housing Form (HTML)

HYATT REGENCY LEXINGTON
Room Reservation Form

2001 International Ash Utilization Symposium
October 22-24, 2001

FAX or MAIL or PHONE

Special rates for this Symposium: US$116.00+tax single, US$126.00+tax double
At the present time, the hotel tax rate in Lexington is 12.6%.
If this form prints on two pages on your printer, please make sure you fax/mail both pages.

Please complete the following:

Dates of reservation        # rooms needed    Disability-related needs, if any:

Arrival: ________________   Single rm:____    ____________________________________

Departure: ______________   Double rm:____    Name of additional person:________________________

Name:___________________________________________________________________________________
Organization:______________________________________________________________________________
Street Address:____________________________________________________________________________
State or Province:__________________________________________________________________________
Postal Code:_______________________________________________________________________________
Country:__________________________________________________________________________________
Home Telephone:___________________________________________________________________________
Work Telephone:___________________________________________________________________________
I understand that I am responsible for one night's room and tax which will be deducted from my deposit or billed through my credit card in the event I do not arrive or cancel within 24 hours of the arrival date indicated.
Signature_________________________________________________________________________________

Reservation Guarantee

Check one:
_______Check enclosed

_______Credit card (Amex, DC/CB, Visa, MasterCard, Discover, JCB)
            Credit Card Number_______________________Exp_____________

Gold Passport G __________________________________

Check in time is 3:00 p.m.; Check out time is 12:00 noon
Please do not mail this form if you have already made your reservations.