Conference and Hospitality Services OSEE – Ecolinks 2013 Thursday May 2nd to Saturday May 4th, 2013 Accommodation Booking Form Your Contact Information: Name: Day-time Telephone # Mailing Address: Street: Prov/State: Country: Email Address: City: Postal/ZIP Code: Residence Accommodation has rooms with one double bed and semi private washroom facilities. If you have a preference for whom to share washroom facilities with please indicate name here: Accommodation must be booked by April 5th, 2013 to Guarantee these rates Accommodation Rates: BED and BREAKFAST PACKAGE (minimum 25 people overnight each night) Gzowski College: One Double Bed per room semi private washroom facilities: Rate $63.00 + 13% tax = $71.19 per person Select applicable nights: May 2ndMay 3rdMay 4th Nightly rate $ 71.19 x # of nights = $ * Deadline for Cancellation April 25th, 2013 * Cancellations after April 25th, 2013 will be subject to one night accommodation charge * No Refunds for early departures or no shows If sending payment electronically the University email system is not guaranteed to be secure. Please call with your payment information. Payment Details: Name on Card Cardholder’s Address Card Number Select Payment Type: Visa MasterCard Institutional Cheque Money Order Bank Draft Expiry Date Cardholder’s Signature Amount of Payment $ (Make Cheques payable to Trent University Conferences Services) Trent University Contact Information: Address: Phone #: Fax #: Email: 1600 West Bank Drive, Peterborough, ON, K9H 7B8 1-866-290-6491 705-748-1209 conferences@trentu.ca -1-