| HOTEL
RESERVATION FORM |
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| We
would like to welcome you as a participant in: |
| 7th
International Conference on Eicosanoids & Other Bioactive Lipids
in Cancer, Inflammation& Related Diseases |
| October
14 - 17, 2001 |
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| Arrial
Date: |
_______________________ |
(Check
in time 4:00 pm) |
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| Expected
arrival time: |
_______________________ |
AM/PM |
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| Departure
Date: |
_______________________ |
(Check
out time is 12 noon) |
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| Please
verify you departure date in order to avoid early departure charges. |
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o
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Single |
$155.00 |
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o
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Double |
$155.00 |
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o
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Non-smoking
room requested |
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| NAME |
_____________________________________________________________________ |
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| Sharing
with |
_____________________________________________________________________ |
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| Organization |
_____________________________________________________________________ |
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| Address |
_____________________________________________________________________ |
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| City |
____________________________ |
State/Country____________________ |
Zip
___________ |
| Special
Requests |
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| ADVANCE
DEPOSIT |
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| All
reservations must be guaranteed with a credit card or one night's
deposit plus tax (tax subject to change w/o notice) |
|
(A)
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check/money
order enclosed |
$_________________ |
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(Please
make check payable to Lowes....) |
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(B)
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Credit
card for guarantee (check credit card used) |
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_____ American
Express |
______
MasterCard |
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(C)
|
Form
of payment at check out: |
______ Credit
Card |
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| Credit
Card Number |
________________________________
Exp. Date _____________ |
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| Print
name as it appears on card ____________________________________________________________ |
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| Signature_____________________________________________________________________ |
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| ALL
GUARANTEED RESERVATIONS NOT CLAIMED OR CANCELLED BY 6:00 PM ON DATE
OF ARRIVAL |
| WILL
BE CHARGED ONE NIGHT'S ROOM AND TAX AS A GUARANTEED NO-SHOW |
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| PHONE: |
|
OR 1-800-336-3335 |
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| Reservations
received after September 13, 2001 will be on a space available and
rate available basis |
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