Student Hotel Reservation Form
Hotel Reservation Form for STUDENT ATTENDEES with valid Student ID
Additional student rooms available at the Dana Inn (directly across the street from the Hyatt Regency):
Dana Inn and Marina 1710 West Mission Bay Drive San Diego, CA 92109-7899 Direct Telephone: 619-222-6440 Reservations: 800-DANA-INN or 800-445-3339 www.danainn.com Specially discounted guest rooms are being held for SIAM student meeting
Student ID will be required upon check-in.
Your reservation is not confirmed until acknowledged in writing by the hotel or verified by phone. 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: $99 per night Rates are subject to prevailing state and local occupancy taxes, currently 10.5% ($110.00). 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 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 (619-222-5916) this reservation form directly to the Dana Inn and Marina. Questions? E-mail email@example.com. CSE03 Home