Student Hotel Reservation Form

Hotel Reservation Form for STUDENT ATTENDEES  with valid Student ID 
SIAM Conference on Computational Science and Engineering (CSE03)
February 10-13, 2003


Complete and mail this reservation form to reach the hotel, by 
Wednesday, January 15, 2003.

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 
attendees until Wednesday, January 15, 2003.  After that date, reservations will 
depend on availability. 

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 protected].

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