Section 1: DELEGATE INFORMATION
| Name: | ____________________________________________________________________ |
| Address: | ____________________________________________________________________ |
| City: | __________________________________ |
| State: | __________________________________ |
| Zip: | __________________________________ |
| Phone (home): | __________________________________ |
| Phone (work): | __________________________________ |
| FAX: | __________________________________ |
| Arrival Date: | __________________________________ |
| Departure Date: | __________________________________ |
Section 2: HOTEL REQUESTED (Please indicate
at least three choices in order of preference.)
| OFFICIAL MEETING HOTELS | CHOICE | 1 Bed 1 Person |
1 Bed 2 People |
2 Beds 2 People |
2 Beds 3 People |
2 Beds 4 People |
| Hampton Inn Downtown | ______ | $104 | $104 | $104 | $104 | $104 |
| Hyatt Regency Indianapolis | ______ | $128 | $128 | $128 | $148 | $148 |
| The Westin Indianapolis (ASAS Headquarter Hotel) | ______ | $120 | $120 | $120 | $140 | $160 |
| Omni Severin Hotel | ______ | $131 | $131 | $131 | $141 | $151 |
| Courtyard by Marriot | ______ | $94 | $94 | $94 | $94 | $94 |
Section 3: TYPE AND NUMBER OF ROOMS REQUESTED
| 1 bed/1 person: ____ | 2 beds/2 people: ____ | 2 beds/4 people: ____ | |
| 1 bed/2 people: ____ | 2 beds/3 people: ____ |
Section 4: GUESTS IN ROOM
| 1.___________________________________ | 3.___________________________________ | |
| 2.___________________________________ | 4.___________________________________ |
Section 5: CREDIT CARD INFORMATION (Must be completed if check or money order is not attached.)
| qAmerican Express qDiscover qMasterCard qVisa qOther________________________ | |
| Card Number:______________________________________________Expiration:_________________ Print name as it appears on credit card:__________________________________ |
Section 6: HOTEL PREFERENCE
| If the hotel of your choice is filled, the ASAS Housing Bureau will do its best to
accommodate housing needs at one of the other conference hotels based on your preference
listed below. Of primary importance (check only one): qHotel location q Room rate |
Section 7: RETURN THIS FORM NO LATER THAN FRIDAY, JUNE 4, 1999 TO
| ASAS Housing Bureau | Indianapolis Convention & Visitors Association One RCA Dome, Suite 100 | Indianapolis, IN 46225 | FAX (317) 684-2492 |