Hotel Reservation FormHotel Reservation Form Additional student rooms available at the Dana Inn (directly across the street from the Hyatt Regency): Hyatt Regency Islandia Hotel & Marina Your reservation is not confirmed until acknowledged in writing by the hotel or verified by e-mail or fax. When making reservations by phone, please identify yourself as an attendee of the SIAM Conference on Computational Science and Engineering. Be sure to get a confirmation number! Please do not send this form to SIAM. Name_______________________________________________________________________ First Middle Initial Last Address______________________________________________________________________ City_______________________________________State________Zip____________________ Telephone_____________________________________________________________________ Fax__________________________________________________________________________ E-mail ________________________________________________________________________ Please reserve a (please circle) Single/Double: $155.00++ per night Rates are subject to prevailing state and local occupancy taxes, currently 10.5% ($171.00). Arrival Date _____/_____ Arrival Time _____:_____AM/PM Departure Date _____/_____ Guarantee my room for late arrival (after 6:00 PM) ____Yes ____No Cancellation policy for non-guaranteed rooms is 24 hours. I choose to pay my deposit for the first night's room rate by (please circle) VISA MasterCard American Express Diners Club Japan Credit Bureau Discover Carte Blanche Credit card no.__________________________________________________________ Exp. Date______/______ Name as it appears on the card: _________________________________________ Signature: ______________________________________________________________ If a credit card is provided, the room is guaranteed for late arrival after 4:00 PM Eastern Daylight Time. Please send me a confirmation notice. Yes _____ No _____ Your e-mail address ________________________ Complete and mail or fax (619-221-4887) this reservation form directly to the Hyatt Regency Islandia Hotel and Marina. Questions? E-mail [email protected]. CSE03 Home |