All reservation must be made through the ITEX Office

YOUR NAME___________________________________________________YOUR COMPANYNAME___________________________________________

Address____________________________________________________City__________________________State______________Zip________________

Phone________________________ Fax__________________ Cell ____________________Email____________________________________________

GUEST NAME ONRESERVATION_____________________________________________________TotalNights___________________

Check-In Date_______________________Check-Out Date_____________________HOW MANY ADULTS? _______CHILDREN? ______

Hotel name: ___________________________________

Smoking Room? (Circle) YES / NO #of BEDS per Room: (Circle)1 / 2 Late Arrival? (after 6pm) YES/ NO

DO YOU NEED RESTAURANT SCRIP? Please list amounts and which restaurant. We have limited amounts so we will try to fill your request.

WHAT OTHER SERVICES WOULD YOU LIKESCRIP FOR? Also use a separate sheet of paper if you need more room.

ITEX ACCOUNT# (if applicable)____________________________________________________________________

Credit Card #___________________________________________________________________Name_______________________________________

Exp. Date____________________ Zip Code your Credit Card Bill is sent to: __________________________________

TERMS AND CONDITIONS

THE FOLLOWING GUIDELINES APPLY TO ALL TRAVEL REQUESTS. BY COMPLETING THIS FORM AND SIGNING IT, YOU ARE AGREEING TO THE FOLLOWING TERMS AND CONDITIONS:

1. ALL RESERVATIONS ARE NON-CANCELABLE, NON-CHANGEABLE, AND NON-REFUNDABLE. ONCE THE REQUEST HAS BEEN PLACED AND A CONFIRMATION NUMBER HAS BEEN GIVEN BY THE HOTEL, it will be considered a finalized deal. All charges are non-refundable once a reservation is confirmed. Any scrip given has the terms and conditions on the back side of the scrip.

2 .RESERVATIONS are based on AVAILABILITY. If booking time is not available, you may pick an alternative date or cancel your reservation request.

3. TAXES, GRATUITIES, AND ANY OTHER MISC.CHARGES SUCH AS PHONE CHARGES ARE TO BE PAID IN CASH directly to the establishment you are patronizing. Taxes & incidentals are the responsibility of the guests and payable in cash. Your credit card, is given to the hotel, as a guarantee of any cash fees owed, damages or missing items that may occur during your stay.

4. The signature on this request is the ITEX member who has authorization to use the account posted on this reservation. By signing below it is acknowledged that the TOTAL Package amount will be posted to your account and authorization is given to charge the credit card posted on this application. Any reversal from your account for this package will revert to CASH owed and deducted from the credit card number listed above.

A $10. booking fee mayl be deducted from your credit card per travel request. If scrip is included, it will be sent priority mail. OVERNIGHT REQUESTS can no longer be processed.

  THIS REQUEST CAN NOT BE PROCESS WITHOUT ALL AREAS FILLED OUT.

x___________________________________________________________________________________________________________________________

  SIGNATURE REQUIREDTO PROCESS YOUR REQUEST DATE

[HOTEL USE ONLY]

Confirmation Number___________________________ Confirmed by______________________________Date Confirmed_________________________