Hotel Request Form

Please use the form below to send us your hotel preferences and requests. We will do our best to accommodate your needs.

Hotel Reservation Request Form

Instructions

FOR STATE TRAVEL, an agency card will be used but for personal travel you must submit a separate form with credit card guarantee for each room reservation request.

Complete all the applicable fields.
Before submitting the hotel reservation form, review the information you have entered to make sure it is correct. An authorization is required for state travel.
Use your web browser print command to print a copy of the hotel reservation form for your own record.
Click the "Send Form" button. Please allow three hours, during normal business hours (9:00-5:30 EST Mon.-Fri.), for a response from an agent.

Personal Information

First Name *

Last Name *

Organization *

Email Address *

Phone Number *

Fax Number

Address *

Address

City

State/Province

Zip/Postal

Country

Hotel Accommodation

Select up to two hotels in order of preference. Properly completed requests will be processed in the order in which they are received. If the hotel of your choice is not available, an alternate comparable property will be offered for your approval.

Note: Submitting a room request does not guarantee that the accommodations you requested will be confirmed for you. Hotel space is limited. If your hotel preferences are not available, an alternative hotel will be assigned to you.

First Hotel Preference *

First Hotel Address *

Second Hotel Preference

Second Hotel Address

Arrival Date *

Anticipated Arrival Time

Departure Date *

Number of People *

Number of Beds

If you know you will be arriving to the hotel late, e.g. after 5PM, please type "Late Check In, DO NOT CANCEL". If you know you will be arriving past 10PM on the day of your check in, please type "Very Late Check In, DO NOT CANCEL"

Comments or Requests *

(Suite, Smoking, non-smoking, ADA, etc. All on a request basis)

Payment

Credit Card Type *

Credit Card Number *

Name on Card *

Expiration Date (MM/YYYY) Ex: 09/2019 *

Authorization Code *

(number on back of card)

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If you are human, leave this field blank.

Instructions

Personal Information

Hotel Accommodation

Payment

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