Registration/Housing Form. DEADLINE: WEDNESDAY, JANuArY 16, 2013.
AFSCME Legislative Conference. February 11 – 13, 2013. Return completed
form by ...
AFSCME Legislative Conference February 11 – 13, 2013
Registration/Housing Form
DEADLINE: WEDNESDAY, January 16, 2013
Washington Hilton • 1919 Connecticut Avenue, NW • Washington, DC 20009 Please print clearly and use ink. Information on all other roommates should be provided on the reverse side. All registrants must complete the payment section at the bottom of the reverse side.
AFSCME Member # ________________________ (See your AFSCME Membership Card or your AFSCME Works address label) Council # ___________ Local # ____________ Retiree Chapter #_______________________________________________ Organizing Campaign Name (if applicable) _______________________________________________________________ Name (Mr./Mrs./Ms.)___________________________________________________________________________________ Mailing Address:
Work /
Personal__________________________________________________________________
City/State________________________________________________________________________ZIP Code____________ E-mail: Work______________________________________________________________________
Personal
Work
Telephone: Work (______)__________________ Home (______)__________________ Cell (______)_________________ Check here to get important text alerts from AFSCME. Message and data rates may apply.
CONFERENCE REGISTRATION ONLY (NO HOTEL NEEDED)
If you do not require housing, what dates will you attend: ____________________________________________
CONFERENCE & HOTEL RESERVATION NEEDED (COMPLETE PAGE 2) Please check appropriate box(es) to indicate special meeting requirements: Sign Language Services
Spanish Translation Services
Dietary Restrictions (please specify)
Other Special Needs: ____________________________________________________________________________ ________________________________________________________________________________________________
AIR Discount In order to benefit from special negotiated airfares, AFSCME encourages participants to contact the following airlines for air travel arrangements: • D elta Airlines 1-800-328-1111 (required Authorization Number- NMF7C) • A merican Airlines 1-800-433-1790 (required Authorization Number- A7423DB) • United Airlines 1-800-426-1122 (required Meeting I.D. Code- ZP56174923)
Return completed form by January 16, 2013 with payment/ guarantee to: AFSCME, Conference & Travel Services, 1625 L Street, NW, Washington, DC 20036-5687 E-mail:
[email protected] or FAX: 202-452-4026 1
Internal Use Only: Local # _______________ State _________________ RHD Code _____________
HOTEL REgistration
Reservations must be made through AFSCME Conference & Travel Services Department. The hotel will not accept reservations directly. AFSCME has secured a block of rooms 3 days before and 3 days after the event. The hotel will require a deposit for incidental charges upon check-in. If the deposit will be made in cash, be advised that the hotel will require $50 per day and will refund any unused funds upon checkout. If a debit or credit card is used, any amount authorized but not used during the stay will be released by the bank card processing center within 7-10 business days after the departure. Should the guest notify the agent upon check-in that they do not wish to have charging privileges during their stay, the agent will then pre-charge the amount equal to room and tax, then release the debit or credit card from any additional authorizations.
Hotel Rates
$229 plus 14.5% tax per room per night ($262.21) – Single/Double Occupancy $254 plus 14.5% tax per room per night ($290.83) – Triple Occupancy $279 plus 14.5% tax per room per night ($319.46) – Quad Occupancy Check-In Time: 4:00 p.m.
Check-Out Time: 11:00 p.m.
Hotel Check-In Date: _____________
Hotel Check-Out Date: ______________
Room Type Please check room type/occupancy level. Type of room is based on hotel availability at time of actual check-in. Single occupancy Double occupancy (1 bed/2 people) Double/Double (2 beds/up to 3 people) Roommate #1 Name: _____________________________ AFSCME Member #:________________ Roommate #2 Name: _____________________________ AFSCME Member #:________________ Roommate #2 Name: _____________________________ AFSCME Member #:________________
Payment/Guarantee (All reservations will require 1 night’s room and tax deposit by credit card, check or money order.) Credit Card (Amex, Visa, MasterCard, Discover) Name of Credit Card Holder _______________________________________ Credit Card Type _____________________ Credit Card #__________________________________________________________ Expiration Date _______________ Credit Card will be charged immediately for 1 night’s room and tax. Check/Money Order (made payable to Washington Hilton) # _________________ Amount $ _______________ If this is a group check, indicate amount to be applied to this specific reservation: $ ____________________________ The Washington Hilton will forward a reservation confirmation directly to the email address provided on page 1.
Cancellation Policy
Please contact hotel directly no later than 72 hours prior to scheduled day of arrival to avoid 1 night’s room and tax charge at 202-483-3000. Please obtain cancellation number for your records.
Return completed form by January 16, 2013 with payment/guarantee to:
2
015-13
AFSCME, Conference & Travel Services, 1625 L Street, NW, Washington, DC 20036-5687 E-mail:
[email protected] or FAX: 202-452-4026
