LODGING for the 2001 Conference

Please print this form out and use it for making lodging reservations.

Please note that the lodging reservations for the 2001 must be sent directly to the hotel, not the Society office. Please contact the hotel directly for any reservation changes, receipts, and cancellations.

Double and multiple occupancy rooms are available. You must make your own roommate arrangements, however. The Society will not be arranging roommates this year.

Registration for the conference must be sent to the Society office as indicated on the Conference registration form.

Lodging Reservation for

Society for Chaos Theory in Psychology & Life Sciences

Annual Conference at UW Madison

Group Code = SCTC

Hello my name is: _________________________________________________________________________

My address is: ____________________________________________________________________________

__________________________________________________________________________________

My e-mail address is: ______________________________________________________________________

My fax number is: ______________________________ Please send me a confirmation, of course!

I would like to reserve one of these rooms (check one) at the rates for the Society conference:

Room tax add 13.5%. Check in time is 4:00 PM. Check out time is 12:00 Noon. Reservations received after 3 July, 2001, will be honored on a space available basis at the rates shown at left.

_____ Single occupancy US$86.00

_____ Double occupancy US$96.00

_____ Triple occupancy US$96.00

_____ Quad occupancy US$96.00

Roll-away beds are an additional $10/night. Do you need any? ________________________

Other special requirements: __________________________________________________________

My arrival date will be Aug. __________, 2001. My departure date will be Aug. _____________

I am guaranteeing my reservation with

_____ A check enclosed, drawn on a US bank (only).

Credit card: ___American Express ______Discover _____MasterCard _____Visa

Card number (Please print clearly): _____________________________________________

Expiration date _________________ Signature ____________________________________

If a cancellation of this booking becomes necessary, to avoid forfeiture of any deposits or payment of penalties, the hotel must receive written notice no later than 6 PM day of reservation.