Attention: Reservation for AMCIS 2000
333 East Ocean Blvd., Long Beach, California 90802
Phone: (562) 436-3000     Fax: (562) 436-9176

Single
$ 135.00
Double
$ 145.00

Please complete the information below and then print the form using the Print button or menu option.
Either fax to the above number or mail the form to the hotel.

Personal Information:
Title: Mr. Mrs. Ms.
First Name:      M.I.
Last Name:
Address:
City:  State:  Zip Code:
Country:
Phone:
Email:

Arrival and Departure Dates:
Arrival Date:
Departure Date:
Preferences:
Number of Guests Per Room:
If Double Occupancy:
              sharing with:
First M.I.
Last
Bedding:
Smoking:
Additional Information
Please enter your mileage program (if any) and your membership number below .
Account Name
Account Number
Group Code
Credit Card Information:
Type of credit card:
Name on card:
Number:
Expiration Date: /

Cancellation policy: Should be made 72 hours prior to arrival.

Note: The first nights room and tax will be charged as a deposit at the time the reservation is made. The deposit will be refundable if cancellation is received at least 72 hours prior to arrival.

**Cutt-Off date for reservations: 7/19/2000.