Hotel Reservation FormHotel Reservation Form Additional student rooms available at the Dana Inn (directly across the street from the Hyatt Regency): Hyatt Regency Islandia Hotel & Marina Your reservation is not confirmed until acknowledged in writing by the hotel or verified by e-mail or fax. When making reservations by phone, please identify yourself as an attendee of the SIAM Conference on Computational Science and Engineering. Be sure to get a confirmation number! Please do not send this form to SIAM. Name_______________________________________________________________________
First Middle Initial Last
Address______________________________________________________________________
City_______________________________________State________Zip____________________
Telephone_____________________________________________________________________
Fax__________________________________________________________________________
E-mail ________________________________________________________________________
Please reserve a (please circle)
Single/Double: $155.00++ per night
Rates are subject to prevailing state and local occupancy taxes, currently 10.5% ($171.00).
Arrival Date _____/_____ Arrival Time _____:_____AM/PM
Departure Date _____/_____
Guarantee my room for late arrival (after 6:00 PM) ____Yes ____No
Cancellation policy for non-guaranteed rooms is 24 hours.
I choose to pay my deposit for the first night's room rate by (please circle)
VISA MasterCard American Express
Diners Club Japan Credit Bureau Discover Carte Blanche
Credit card no.__________________________________________________________
Exp. Date______/______
Name as it appears on the card: _________________________________________
Signature: ______________________________________________________________
If a credit card is provided, the room is guaranteed for late arrival after
4:00 PM Eastern Daylight Time.
Please send me a confirmation notice. Yes _____ No _____
Your e-mail address ________________________
Complete and mail or fax (619-221-4887) this reservation form directly to the
Hyatt Regency Islandia Hotel and Marina.
Questions? E-mail meetings@siam.org.
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