Hotel Reservation Form

Radisson University Hotel-MPLS
615 Washington Avenue S.E.
Minneapolis Minnesota 55414
Reservations: (800) 333-3333 USA and Canada
Telephone: +1-612-379-8888
Fax: +1-612-379-8682
http://www.radisson.com/univ_minneapolis

Specially discounted guest rooms are being held for meeting attendees through Monday, April 17, 2006. After that date, reservations will depend on availability. SIAM negotiates to get the best possible rate for attendees at the host hotel. Your support in staying at the Radisson University Hotel-MPLS helps keep SIAM conference registration fees down, which directly affects you as an attendee.

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 Conference on Imaging Science. Be sure to get a confirmation number!

PLEASE DO NOT SEND THIS FORM TO SIAM.

Name________________________________________________________________________
(First - Middle Initial - Family )

Address______________________________________________________________________

City________________________________State________Zip_______ Country_____________

Telephone__________________________FAX___________________

Please reserve a:

Single/double $115 per night plus 13% tax
Student rate $85 per night plus 13% tax

(Student ID must be presented upon check-in. SIAM is able to negotiate only a limited number of special student rate rooms. Please book early as these rooms sell out quickly!)

All rooms based on availability.
All rates are subject to state and local occupancy taxes.

Arrival date _____/_____ Arrival time _____:_____AM/PM

Departure date _____/_____

A credit card is required to guarantee your room.
I choose to guarantee my room by:

Credit Card #_______________________________________Exp. Date ________________

Name as it appears on credit card _______________________________________________

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

Signature __________________________________________________________________

Please send me a confirmation notice. Yes____No ____

E-mail address/fax number: ___________________________________________

ALL RESERVATIONS MUST BE GUARANTEED WITH CREDIT CARD OR DEPOSIT.

Complete and mail or fax this reservation form directly to the Radisson University Hotel-MPLS. Contact information for the hotel appears at the top of this page.

Questions? E-mail [email protected]