b"1996MRCAHOUSINGFORM I.Use this offici form to make hotel reservations. No phone reservations will be accepted. Form must be mailed or faxed to the al Indianapolis Convention&Visitors Association. Please submit one form per room. To make additional reservations, please photocopy this form. 3.A one night's deposit is required to hold each reservation. Checks must be made payable to the MRCA Housing Bureau. You may al authorize a credit card payment below.In the event of noncancellation, prior to 48 hours in advance ofarrival, the soscheduled deposit becomes nonrefundable. 4.Room confirmations will be sent directly from the hotel. Reservations sent after October 3,1996, willbe confirmed on a space available basis and must be made directly with the hotel. NAME __________________ __TITLE_______ _ _ _ ______ COMPANY _ _ ____ ______ _ _____ _______ ___ _ _ ______ ADDRESS - - - - - - - - - - -CITY________ _____ ___ _ _STATE _ ______ZIP _ _ _ ___ _ __ _TELEPHONE _ _ _____ ___ _ ___ _ _ _FAX____ _ _____ _ _ _ _ _ __ _ARRIVAL DATE ___ __________DEPARTURE DATE _ _ _ _ _ _ ______ ___Please list any special requirements you may have___ _________ ___ _ _ _____ _ ____ __ _N ONSMOKERSMOKER PLEASE INDICATE YOUR I ST, 2ND AND 3RD CHOICES BELOW SEVERIN HOTELPLAZASUITES H OTEL OMNICROWNEEMBASSY (Two blocks east of(Two blocks southeast of(Two blocks northeast of convention convention center)convention 40 West Jackson Placecenter atUnion S ion)center)I IOWashington Street tat West Single$ 107123 West Louisiana StreetSingle$ 125* Double-King$117Single$103Double-King$ 135* Double-Double$ 117Double-King$118Trip le$145* Doubl uble$1 18 e-Do Quad$ 155* *Includes cook to order breakfast and complimentary cocktails 5:30-7:30 p.m. alPlease list the name(s) ofl additional room occupants CREDIT CARD AUTHORIZATION By signing below, I authorize the hotelcharge a one night's deposit to the following credit card. to I understand I will forfeit my deposit in the event I do not cancel my reservationwithin 48 hours ofscheduled arrival date. my American ExpressDiscoverMasterCardVISA Signature- - - - - - - - - -~ard Number _____________ ________ ____Exp. Date _____________SEND TO: MRC AH OUSING BUREAU,INDIANAPOLIS CONVENTION&V ISITORS ASSN., ONE RC ADOME, STE.I 00, INDIANAPOLIS,IN 46225 ORFAX3 17/684-2492"