International Conference on Logic Programming (ICLP'99)

November 29 - December 4, 1999 New Mexico State University, Las Cruces, New Mexico

Accommodation Form

Last name	:	..........................................................................
First name	:	..........................................................................
Title	:	.......................
E-mail address	:	..........................................................................
Street	:	..........................................................................
City	:	............................................................................. Postal code: ..............
Country	:	..........................................................................
Tel.	:	.............................................. Fax: ..............................................
Accompanying person(s)	:	..........................................................................

I would like to reserve a room at: ...........................................................................
to attend ICLP'99 at New Mexico State University

Arrival date : ...................................

Departure date : ..................................

Nr. of nights : .....

Single room [ ]

Double room [ ] Triple room [ ] Quad room [ ]

(Please tick appropriate box).

Smoking [ ]

Nonsmoking [ ]

(Please tick appropriate box).

Payment

The total amount must be paid directly to the hotel when checking out. All major credit cards are accepted. A credit card number is required to hold the room if you plan to arrive after 6 pm.

[ ]	Number of Credit Card : ............. ............. ............. ............. Expiry date : ......................... Name of the Cardholder : ......................................... Signature : ......................................

Please return by postal mail or fax 1 copy of this form directly to the Hotel.

Date : .........................................

Signature : ...........................................