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Name                            Company

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Address                                          City           State        Postal Code       Country

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Arrival Date & Approximate Time                   Departure Date
(Check-In Time is after 3:00 pm)                   (Check-Out Time is prior to 12 Noon)     

A block of rooms has been reserved at the Grand Hyatt Hotel at the PSAM 4 special rate of $180 per night, for either single or double occupancy Twenty five rooms per night will also be available at the U.S. government rate of $173 for single occupancy. All rates are subject to state, local and occupancy taxes which are 13.25% and $2.00 per room night occupied). In order to qualify for these rates, PSAM 4 attendees MUST use this registration form. All reservations must be in by August 15, 1998 to ensure the conference. Any reservations received after August 15, 1998 are subject to hotel space and rate availability. THE NUMBER OF ROOMS IS LIMITED - PLEASE MAKE YOUR RESERVATIONS EARLY.

Type of accommodation requested: (Check One)     q Single             q Double

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Name of Additional Person Sharing Room

Hotel will make every effort to honor special requests, however they cannot be guaranteed. If rate requested is not available, lowest available rate will be confirmed.
Business Plan accommodations (Computer hookup, fax machine access, and Continental breakfast) are offered an additional charge of $15.00 per room (based on availability)

Reservations will be held until 6pm unless accompanied by a deposit or an accepted credit card number and signature.
Please hold my reservation for: (Check One)
    r 6:00 PM Arrival
    r Guaranteed by first night’s deposit (Check or Money Order enclosed)
    r Guaranteed by my Credit Card

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Type of Credit Card                             Credit Card Number                   Expiration Date

EARLY DEPARTURE FEE:
At check-in, guests will be asked to reconfirm their departure date. In the event of an early departure, a fifty ($50.00) dollar fee will be charged.
FOR GUARANTEED RESERVATIONS ONLY
I understand that I am liable for one night’s room and tax which will be deducted from my deposit, or billed to my credit card in the event that I do not arrive or cancel by 6:00 pm on the arrival date indicated.

Signature:______________________________________