ENCLOSE IN ENVELOPE AND MAIL TO:

ACVB Housing Bureau
	201 E. 2nd Street
	Austin, Texas 78701

2000 Administrators’ Midwinter Conference on Education

or FAX to: (512) 583-7283
(Telephone requests not accepted.)

OFFICIAL HOUSING REQUEST FORM

*PLEASE PRINT OR TYPE ALL ITEMS TO ASSURE ACCURACY.
*COMPLETE EACH PART BELOW IN DETAIL FOR CORRECT AND RAPID PROCESSING.
*CONFIRMATIONS WILL BE SENT TO THE FIRST INDIVIDUAL INDICATED IN EACH ROOM REQUESTED.

NAME OF PERSON REQUESTING ROOMS

(First Name)	(Last Name)	(M. Initial)

(Name of Company)

(Street Address or P.O. Box Number)	   (Area Code) Phone #	   Fax #

(City)	   (State)	   (Zip)

(Credit Card)	   (Number)	   (Expiration Date)

INSTRUCTIONS:  Select FOUR Hotels/Motels of your choice in order of preference.  No request will be processed without FOUR choices.  If choices are not available, which is more important? (please check one)  	Room Rate   	Location 

(First Choice)		(Second Choice)

(Third Choice)		(Fourth Choice)

INSTRUCTIONS:	Print or type names of all persons occupying each room.
	Select type of room desired with arrival and departure dates.  Note: Room type requested is not guaranteed.
	Rooms with two beds are limited, therefore, priority will be given to rooms with 3 or more occupants.

ARRIVAL DATE:

DEPARTURE DATE:

ARR. TIME:

SMOKING	   	
	YES    NO

CHECK ONE

	SINGLE (1 RM-1 PER-1 BED)
	DOUBLE (1 RM-2 PPL-1 BED)
	DBL/DBL (1 RM-2 PPL-2 BEDS)
	TRIPLE (1 RM-3 PPL-2 BEDS)
	QUAD (1 RM-4 PPL-2 BEDS)
	SUITE (N/A @ CONF. RATE)

	Check for handicap accessibility

ROOM 2           OCCUPANT’S NAME/S (PRINT LAST NAME FIRST)

1.	

2. 	

3. 	

4. 	

ARRIVAL DATE:

DEPARTURE DATE:

ARR. TIME:

SMOKING	   	
	YES    NO

CHECK ONE

	SINGLE (1 RM-1 PER-1 BED)
	DOUBLE (1 RM-2 PPL-1 BED)
	DBL/DBL (1 RM-2 PPL-2 BEDS)
	TRIPLE (1 RM-3 PPL-2 BEDS)
	QUAD (1 RM-4 PPL-2 BEDS)
	SUITE (N/A @ CONF. RATE)

	Check for handicap accessibility

ROOM 1           OCCUPANT’S NAME/S (PRINT LAST NAME FIRST)

1.	

2. 	

3. 	

4. 	

DEPOSIT INFORMATION:
Deposit requirements vary from hotel to hotel.  If you did not supply a major credit card and expiration date, please contact your assigned hotel regarding their specific deposit requirements for securing your room prior to arrival.  If a credit card number is not supplied, a deposit in the form of a check may be required to secure your reservation.  DO NOT SEND A CHECK TO THE HOUSING BUREAU WITH YOUR RESERVATION REQUEST.  All cancellations and changes prior to cut-off should be made through the ACVB Housing Bureau at 800-926-2282.

CUTOFF DATE
HOUSING FORMS MUST BE RECEIVED BY DECEMBER 17, 1999