Association of Nigerian Physicians in the Americas - dc (Page 13)

Association of Nigerian Physicians in the Americas dc Page 13

HOTEL REGISTRATION FORM

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Annual Convention of the Association of Nigerian Physicians in the Americas

"A Healthier Nigeria in A Healthier World"

June 28 -July 2, 2000 · Washington D.C.

All reservations must be received by May 31, 2000 and accompanied by a first night room deposit, or guaranteed
with a major credit card. Room rates are effective two (2) days before and after conference dates based on space and
rate availability.

Name ____________________________________________________________________________________________________

Organization ______________________________________________________________________________________________

Street Address ____________________________________________________________________________________________

City

____________________________ State ________________________________ Zip ______________________________

Arrival Date ______________________ Departure Date__________________________________________________________

Please mail or fax this form directly to Hotel

Register Early ­ Limited number of discounted rooms

Send check or credit card information directly to;

Check Enclosed

Please charge my:

American Express, Diners Club, Discover, MasterCard, Visa for one night and tax deposit

Card Holder ____________________________________________________________ Phone (______) ____________________

Card #

__________________________________________________________________________________________________

Signature ________________________________________________________________________________________________

Hotel Registration

(Please check which applies)

Nightly Rates

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Single ........................................................................................$175.00

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Double ......................................................................................$175.00

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Parlor + 1 Connector ...............................................................$225.00

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Parlor + 2 Connectors ..............................................................$275.00

JW Marriott Hotel

1331 Pennsylvania Avenue, NW

Washington, DC 20004

(800) 228-9290