Hotel Reservation - The International Congress Of Esthetics And Spa

PLEASE FILL THE ENTIRE FORM

Please select a first and second hotel choice:

First Choice:

Second Choice:

Rates/Room Type

Rates/Room Type

Accommodations

How many rooms?

Arrival Date:

Departure Date:

Are you an attendee or exhibitor?

Smoking Preference:

Bed Preference:

Room Type:

Name of guest(s) for this reservation:

Special Requests:

Room 2

Arrival Date:

Departure Date:

Smoking Preference:

Bed Preference:

Room Type:

Name of guest(s) for this reservation:

Special Requests:

Room 3

Arrival Date:

Departure Date:

Smoking Preference:

Bed Preference:

Room Type:

Name of guest(s) for this reservation:

Special Requests:

Room 4

Arrival Date:

Departure Date:

Smoking Preference:

Bed Preference:

Room Type:

Name of guest(s) for this reservation:

Special Requests:

Room 5

Arrival Date:

Departure Date:

Smoking Preference:

Bed Preference:

Room Type:

Name of guest(s) for this reservation:

Special Requests:

Room 6

Arrival Date:

Departure Date:

Smoking Preference:

Bed Preference:

Room Type:

Name of guest(s) for this reservation:

Special Requests:

Room 7

Arrival Date:

Departure Date:

Smoking Preference:

Bed Preference:

Room Type:

Name of guest(s) for this reservation:

Special Requests:

Room 8

Arrival Date:

Departure Date:

Smoking Preference:

Bed Preference:

Room Type:

Name of guest(s) for this reservation:

Special Requests:

Room 9

Arrival Date:

Departure Date:

Smoking Preference:

Bed Preference:

Room Type:

Name of guest(s) for this reservation:

Special Requests:

Room 10

Arrival Date:

Departure Date:

Smoking Preference:

Bed Preference:

Room Type:

Name of guest(s) for this reservation:

Special Requests:

Contact Information

First Name:

Last Name:

Mailing Address:

City:

State:

Zip Code:

Home Phone:

Business or Other Phone:

Email Address:

Payment Method

Card Number:

Expiration Date:

Name On Card:

Card Type: