Hotel Form Example

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HOTEL RESERVATION FORM The following special room rates are included service charge, tax and breakfast which will be offered to the participants during 2014 FMA Asian Conference. Arrival Date/Time : Departure Date/Time : □ Executive floor Double Room / Single Use □ Smoking Room □Prof. □Dr. □Mr. \29,600 □ Executive floor Double Room / Double Use \34,000 □ Non Smoking Room □Ms. *Please Print First Name: Middle Name: Last Name: Mailing Address: Zip Code: Phone: + E-mail: Country: Fax: + Accompanying Person’s Name: The above rate is inclusive of 10% service charge, 5% consumption tax and JPY 200 of Tokyo accommodation tax. In accordance with the relevant regulations in Japan we will be taking a photo copy of the passport upon check in. =Executive Floor Benefits = * Daily Buffet Breakfast * Free high speed internet access in the guest rooms * Access to Executive Lounge * Access to Fitness & Swimming Pool = Cancellation Policy = 1 day prior to accommodation day Accommodation day No Show Note : 1.Please use one form for one room. : : 20% of room charge 80% of room charge 100% of room charge 2.The hotel reservation will be accepted while the rooms are available. Deadline for advance registration: APR 8, 2014 8, 201 PLEASE RETURN THE FORM TO: Please return this Application Form by e-mail or fax. or FAX : +813-3272-1220 □ FAX Confirmation Confirmation return to : □ E-mail Information Hotel Information : □ Accepted Confirmation No.: Remarks: 〒103-8520 東京都中央区日本橋蛎殻町 2-1-1 2-1-1 Nihonbashi-Kakigara-cho, Chuo-ku, Tokyo 103-8520, Japan Phone:+81-(0)-3-3667-1111 Facsimile:+81-(0)-3-3667-1115 Email: □ Not Accepted Clerk:

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