CHI '95 HOUSING RESERVATION FORM

To Register for Housing: 

Complete the Housing Form 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: ______________________________________________________

Sharing with: ______________________________________________________

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): 

______________________________________________________

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