national society of black engineers 41 annual convention
NATIONAL SOCIETY OF BLACK ENGINEERS 41ST ANNUAL CONVENTION ANAHEIM, CA * MARCH 25 - 29, 2015 MEMBER HOUSING REQUEST FORM Instructions:
Please complete this form and return to NSBE Housing NO LATER than February 20, 2015. Please contact NSBE Housing/Wyndham Jade with any changes. Do not contact the hotel directly. Deposits and names are due at time of booking. Your reservation(s) will not be processed without names and payment information.
Personal Information
Please type or print legibly
First Name:
Confirmation of reservation(s) will be sent to email address provided on form Last Name:
Company/Organization: Address: City:
State/Province:
Zip/Postal Code :
Country:
E-Mail :
Phone :
Fax :
Hotel / Guest Room Information
Reservation cut off: February 20, 2015
Anaheim Convention Center, 800 W. Katella Ave. Anaheim, CA 92802
______1. Anaheim Marriott – Rates from $189 per night + tax ______2. Hilton Anaheim – Rates from $189 per night + tax
Each line represents one room. Please print the first/last names of one of the persons occupying each room. Please insert a “placeholder” name if a specific name is not known at the time of completion. (Do not use “TBD”). If additional lines are required, please copy this form as needed.
Name Joe Attendee
# of Beds
Arr. Date
Dep. Date
2
3/25
3/29
Credit Card or Check Number xxxx-xxxx-xxxx-xxxx
Exp Date
Roommate 1
Roommate 2
Roommate 3
04/15
Bob Roommate
John Roommate
Tom Roommate
Payment Information
($4 Credit Card Processing Fee is Non-Refundable)
Paying by credit card: One night’s room and tax and a one-time non-refundable processing fee of $4.00 will be charged to your credit card immediately. Payment by Check: Your reservation is not guaranteed until your deposit is received. Checks must be in U.S. dollars, drawn from a U.S. bank and payable to NSBE Housing/Wyndham Jade. Checks not made payable to NSBE Housing/Wyndham Jade will be returned. Send completed 2015 NSBE hotel request form to: Email [email protected]
Phone / Questions 888-241-8407 (U.S./ Canada) 972-349-7486 (International) Mon-Fri, 8am-6:30pm CST
Fax 972.349.7715
Mail NSBE/Wyndham Jade Housing 6100 W. Plano Parkway, Ste. 3500 Plano, TX 75093
Please complete this form and return to NSBE Housing NO LATER than February 20, 2015. Please contact NSBE Housing/Wyndham Jade with any changes. Do not contact the hotel directly. Deposits and names are due at time of booking. Your reservation(s) will not be processed without names and payment information.
Personal Information
Please type or print legibly
First Name:
Confirmation of reservation(s) will be sent to email address provided on form Last Name:
Company/Organization: Address: City:
State/Province:
Zip/Postal Code :
Country:
E-Mail :
Phone :
Fax :
Hotel / Guest Room Information
Reservation cut off: February 20, 2015
Anaheim Convention Center, 800 W. Katella Ave. Anaheim, CA 92802
______1. Anaheim Marriott – Rates from $189 per night + tax ______2. Hilton Anaheim – Rates from $189 per night + tax
Each line represents one room. Please print the first/last names of one of the persons occupying each room. Please insert a “placeholder” name if a specific name is not known at the time of completion. (Do not use “TBD”). If additional lines are required, please copy this form as needed.
Name Joe Attendee
# of Beds
Arr. Date
Dep. Date
2
3/25
3/29
Credit Card or Check Number xxxx-xxxx-xxxx-xxxx
Exp Date
Roommate 1
Roommate 2
Roommate 3
04/15
Bob Roommate
John Roommate
Tom Roommate
Payment Information
($4 Credit Card Processing Fee is Non-Refundable)
Paying by credit card: One night’s room and tax and a one-time non-refundable processing fee of $4.00 will be charged to your credit card immediately. Payment by Check: Your reservation is not guaranteed until your deposit is received. Checks must be in U.S. dollars, drawn from a U.S. bank and payable to NSBE Housing/Wyndham Jade. Checks not made payable to NSBE Housing/Wyndham Jade will be returned. Send completed 2015 NSBE hotel request form to: Email [email protected]
Phone / Questions 888-241-8407 (U.S./ Canada) 972-349-7486 (International) Mon-Fri, 8am-6:30pm CST
Fax 972.349.7715
Mail NSBE/Wyndham Jade Housing 6100 W. Plano Parkway, Ste. 3500 Plano, TX 75093
