***************************************************** *RESERVATION FORM - THE ADAMS MARK HOTEL - ST. LOUIS* ***************************************************** IMPORTANT INFORMATION --------------------- Return Form by : April 22, 2005 Return Form to : Email - Cmontini@adamsmark.com FAX - (314) 241-6618 Phone - (314) 241-7400 or (800) 444-ADAM (toll free in the U.S. only) Mail - Adams Mark St. Louis (Attn. Reservation Dept.) Fourth & Chestnut St. Louis, MO 63102 U.S.A. Check-in Time : 3:00 P.M. Check-out Time : 12:00 Noon > Taxes are subject to change. Current tax percentage is 14.866%. > Cancellation or modification of reservation must be made at least 72 hours prior to arrival to avoid forfeiture of deposit. Ask for and retain cancellation number until you receive refund of deposit or credit to credit card. > No charge for children under 18 when sharing room with parents and using existing bed space. > All hotel accounts are subject to credit arrangements at time of registration and payable at departure. __________________________________________________________________________________________________________________ The Adam’s Mark St. Louis is pleased to host the International Conference on Software Engineering. To ensure accurate reservations, please complete this reservation request and return it before APRIL 22, 2005. Requests received after this date will be accepted based on room and rate availability. Reservation requests must be accompanied by a deposit equal to one night’s room rate plus 14.866% tax. This deposit will be applied to the last night of the reservation. RESERVATION REQUEST ------------------- Number of Guests : _______ Room Type Preference (Please put an 'X' next to your choice): ------------------------------------------------------------- Special Group Rate : ( ) Single-$134 ( ) Double-$144 ( ) Triple-$154 ( ) Quadruple-$164 Concorde Level Room: ( ) Single-$164 ( ) Double-$174 ( ) Triple-$184 ( ) Quadruple-$194 Special Requests (subject to availability): ------------------------------------------- ( ) Roll Away Bed-$15 per night - restricted to rooms with only one bed ( ) Wheelchair accessible room ( ) Non-smoking room ( ) King Bed ( ) Two Double Beds ( ) Crib Guest Information: ------------------ Name : ___________________________________________ Address : ___________________________________________ ___________________________________________ City / State / Zip : ___________________________________________ Telephone : ___________________________________________ Reservation Details: -------------------- Arrival Date (MM/DD/YY) : ___________________________________________ Arrival Time : ___________________________________________ Departure Date (MM/DD/YY) : ___________________________________________ Additional Guests : ___________________________________________ Payment Information: -------------------- ( ) Check in the amount of one night’s room rate plus 14.866% occupancy tax. ( ) MasterCard ( ) Visa ( ) American Express ( ) Discover ( ) Carte Blanche/ Diners Club ( ) JCB Card Number: ___________________________________ Exp. Date (MM/YY): __________________________ I UNDERSTAND THAT I AM LIABLE FOR ONE NIGHT’S ROOM RATE PLUS 14.866% OCCUPANCY TAX WHICH WILL BE COVERED BY MY DEPOSIT IN THE EVENT THAT I DO NOT ARRIVE, CANCEL LESS THAN 72 HOURS PRIOR TO ARRIVAL, OR DEPART EARLIER THAN SCHEDULED. _____________________________________________ _________________________________________ NAME OF CREDIT CARD HOLDER SIGNATURE OF CARD HOLDER