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Housing Request Form

ACRL is taking care of your room reservation and the billing. We need you to complete the information below so that a room is held under your name.

 NAME:
 MAILING ADDRESS:
 
 City: State:          Zip:         
 PHONE NO.:
 FAX NO.:
 E-MAIL:

 MEETING:
 

Occupant(s)

1.

2.

3.

4.

5.

Arrival Date:

 

Arrival Time:

 

Departure Date:

 

 Select type of room desired

___ Single (One person/one bed)

___ Double (Two people/one bed)

___ Double/Twin (Two people/two beds)

___ Triple (Three people/1–2 beds)

___ Quad (Four people/two beds)

Special requests

_____ Smoking _____ Non Smoking