THE
UNIVERSITY
OF MANITOBA
A. V. MAURO
RESIDENCE -
ACCOMMODATION
RESERVATION
FORM
MADLaT 2006
Conference
May 4 &
5,
2006
Last Name:
First Name:
Organization:
Street Address:
City/Town:
Province/State:
Postal/Zip Code:
Telephone:
Fax:
Email:
Arrival Date & Time
Departure
Date
PAYMENT
INFORMATION:
send
your
cheque
or money
order
payable
to: The
University
of
Manitoba
in
Canadian
Funds or
indicate
choice
of
credit
card.
Faxed
forms
require
a credit
card
authorization:
I authorize payment of accommodation
$
by VISA / or MASTERCARD
Complete
card no:
Expiry
Date:
month/year
cardholder's
signature
date
signed
Payment
MUST BE
IN FULL
and
postmarked
no later
than
midnight
April
25,
2005.
Please
print
and
send
this
Request
for
Accommodation
form
to
the
address
or
fax
number
below:
The
University
of
Manitoba,
Special
Functions
Department,
Room
230,
University
Centre,
Winnipeg,
Manitoba
R3T 2N2
Tel.
(204)
474-8337,
Fax.
(204)
474-7569
GST
R#
119260669
In the
event of
cancellation
under 48 hours
or “no show”
your payment
will be
refunded less
the first
night.
All taxes
are included
in the rates
quoted. ALL
CHEQUES MUST
BE IN CANADIAN
FUNDS.
Payment
may be
personal
cheque, money
order, VISA or
MASTERCARD
only.
*
Full
suite
night(s)
at
$157.32
per
night
*
Bedroom
1:
night(s)
at
$78.66
per
night
(taxes incl.) = $
Admin
Fee
(one time only) = $ 5.00
TOTAL = $
1
person
(self
only)
2
people
-
name
of
roommate
*
Bedroom
2:
If
you
are
sharing
a
two
bedroom
suite
with
a
specific
person/persons,
please
provide
their
name(s)
&
city
of
origin
so
we
can
slot
them
into
the
other
bedroom
upon
receipt
of
their
form.
Suite-mate(s):
Will you
require a
parking
space near
the Mauro
Residence?
Yes
No
Parking
passes and
continental
breakfast
are included
with
residence
rooms in
A.V. Mauro.
Please Note:
Each suite
has two
bedrooms,
bathroom
with shower
and a
kitchenette.
The
kitchenette
contains a
fridge,
microwave,
table with
chairs, and
a kettle.
Each bedroom
has a double
bed,
armoire, air
conditioning,
colour
television,
telephone,
internet
access &
clock radio.
Daily maid
service is
provided as
well as all
bed linens,
towels, soap
& glasses.
The suites
are not
equipped
with hair
dryers or
coffee
makers.
Internet
access
available.
The Mauro
Residence is
handicapped
accessible
and
“accessible
suites” are
available
upon
request.
This
personal
information
is being
collected
under the
authority of
The
University
of Manitoba
Act. It will
be used for
the purposes
of
registration,
and
communication
with the
participant.
It may be
shared with
other
educational
institutions,
government
departments,
and
co-sponsoring
organizations.
It is
protected by
the
Protection
of Privacy
provisions
of The
Freedom of
Information
and
Protection
of Privacy
Act. If you
have any
questions
about the
collection
contact the
FIPPA/PHIA
Coordinator’s
Office,
University
of Manitoba
Archives &
Special
Collections,
331
Elizabeth
Dafoe
Library,
Winnipeg,
MB, Canada
R3T 2N2
(tel.
204-474-8339).