Hotel Reservation Form

Complete and mail this reservation form to the hotel.  It must arrive on or before Friday, August 10, 2001.

Reservations
The Boston Park Plaza Hotel
64 Arlington Street
Boston, MA 02116-3912
617-426-2000 Phone
617-423-1708 Fax
800-225-2008 Reservations
http://www.bostonparkplaza.com

Specially discounted guest rooms are being held for SIAM meeting attendees until Friday, August 10, 2001.  After that date, reservations 
will depend on availability. Your reservation is not confirmed until acknowledged in writing by the hotel or verified by phone. When making 
reservations by phone, be sure to identify yourself as an attendee of the SIAM Conferences on Imaging Science and Life Sciences. 
Be sure to request 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: $165.00
Double:   $180.00

Rates are subject to prevailing state and local taxes @ 12.45%
Each additonal person in room $20.00

Arrival Date _____/_____      Arrival Time _____:_____AM/PM

Departure Date _____/_____

Guarantee my room for late arrival (after 6:00 PM) ____Yes ____No  

I choose to pay my deposit for the first night's room rate by (please circle)

VISA        MasterCard         American Express         Check 

Credit card no.__________________________________________________________

Exp. Date______/______

Please send me a confirmation notice.            Yes _____   No _____   

Your e-mail address _______________

Complete and mail or fax this reservation form directly to The Boston Park Plaza Hotel.

Questions? E-mail meetings@siam.org.

SIAM wishes to take steps to ensure that no individual with a disability is excluded, denied services, segregated or otherwise 
treated differently than other individuals because of the absence of auxiliary aids and services. If you need any auxiliary aids or 
services identified in the Americans with Disabilities Act, or assistance in registering for this conference/meeting, please notify 
the hotel when making reservations.