Hotel Reservation

Marina Beach Marriott Hotel Reservation Form

2003 VMIC CONFERENCES
SEPTEMBER 22 - 25, 2003

APPLICATION FOR HOTEL ACCOMMODATIONS - Marina Beach Marriott
Reservations request must be received by September 8, 2003

Mail Directly to:
Marina Beach Marriott Hotel
4100 Admiralty Way
Marina Del Rey, CA 90292

Fax 310-448-4870
Phone 310-301-3000
Reservations 1-800-228-9290

Indicate VMIC or IMIC Assoc.

Do NOT send with Conference
Registration Card. Send directly
to the Hotel.

Name: (type or print): Last__________________ First__________________ Middle________________

Firm/University

Address:

City/Country/Zip:

Phone: FAX: Email
Arrival Date: Departure Date:

Room type: Single___________________ Double___________________ Double-Double___________________________

Reservations must include first night's deposit in the form of a credit card of check. Check in time is 3 P.M.

Company Credit Card.

Please circle one: MC VISA AMX CB DC OTHER

Card Number___________________________________Expiration Date:_______________

Schedule of Rates
Single Occupancy/Double/Double-Double Occupancy - $159.00

2003 VMIC CONFERENCES SEPTEMBER 22 - 25, 2003 APPLICATION FOR HOTEL ACCOMMODATIONS - Marina Beach Marriott Reservations request must be received by September 8, 2003 Mail Directly to: Marina Beach Marriott Hotel 4100 Admiralty Way Marina Del Rey, CA 90292 Fax 310-448-4870 Phone 310-301-3000 Reservations 1-800-228-9290 Indicate VMIC or IMIC Assoc. Do NOT send with Conference Registration Card. Send directly to the Hotel.
Name: (type or print): Last__________________ First__________________ Middle________________
Firm/University
Address:
City/Country/Zip:
Phone:			FAX:			Email
Arrival Date: Departure Date:
Room type: Single___________________					Double___________________	Double-Double___________________________
Reservations must include first night's deposit in the form of a credit card of check. Check in time is 3 P.M.
Company				Credit Card.
Please circle one:	MC	VISA	AMX	CB	DC	OTHER
Card Number___________________________________Expiration Date:_______________