Society for Behavioral Neuroendocrinology
University of Virginia 1999 Housing Reservation Form
June 26 - June 30, 1999
To reserve accommodations, please do one of the following: Reservation Deadlines
This form is due to Conference Services on or before May 26, 1999.
Late Reservation Fee: $25.00 for all reservations received after the above deadline.
We cannot guarantee accommodations for reservations submitted after the deadline, but will make every effort to meet your request.
Name:                                                                                                   Social Security #:                                                                    

Street:                                                                         City:                                                        State:                      Zip:
E-mail Address:                                                                             Number of persons in party:                                                          

Daytime Phone Number:                                                                               Fax #:                                                                             

Arrival date:                                                                            Departure date:                                                                                     

Handicapped-accessible accommodations required (circle one): Yes     No    If yes, explain nature of disability: 

Accommodations:  Please check the desired accommodations
Accommodations
 
Nightly rate per person
 
Circle One
 
Smoker? Yes/No
  
Brown College Single Occupancy Suite
 
37.50 per person/night
 
Male/Female/Couple
  
  
Brown College Double Occupancy Suite
 
$22.50 per person/night
 
Male/Female/Couple
  
  
Bice House Double Occupancy Room
 
$22.50 per person/night
 
Male/Female/Couple
  

  
Housing Charges:
 
$
 
Payment Method:
 
Check                  Visa                Master Card
 
Dining Charges
 
$       *43.05
 
Card Holder Name:
   
Late Reservation Fee (if applicable):
   
Credit Card Number:
   
TOTAL AMOUNT DUE:
 
$
 
Expiration Date:
   
Checks and Credit Cards are processed upon receipt.  Checks should be made out to the University of Virginia.  Guests will receive confirmation of their reservation prior to their arrival.

Signature:__________________________________________________________
Payment/Cancellations Payment in full must be included with reservation form. Guests who fax their reservation must include a valid credit card number (Visa or Master Card) for payment. Guests who mail their reservation form may pay by check or credit card. However, all guests must include a valid credit card number which will be used as a deposit for the room keys (see instructions). DO NOT send cash in the mail.  Cancellation notifications must be received by Conference Services at least 7 working days prior to your arrival in order for you to receive a full refund. If a guest cancels between 7 days prior to their scheduled arrival date and their arrival date, the guest will be charged for one night. No refunds will be given once you arrive. Refunds may take 4-6 weeks to process if you pay by check; credit card refunds will be credited within 48-hours. All cancellations must be received in writing.