Name:
Institution:
City:
State/Province:
ZIP/Postal Code:
Phone:
Fax:
How many rooms:
Arrival (month/day/year):
Departure (month/day/year):
Number of adults:
Type of room: Single / Double
Would you prefer: Smoking / Non-Smoking
Credit Card Name: AmEx / Mastercard / Visa
Name on Card:
Credit Number:
Card Expiration Date:
I request the $125/day (single/double)
special rate for IEEE Computer Society FOCS 2000.