Year 2 or Year 3 - Lodging Package Registration Form

Registration Deadline: Monday, September 15, 2008. After this date all room assignments & arrangements are final.
All Registration is to be done online and must include a valid credit card. Incomplete registrations will not be processed.
FILL OUT ONE FORM PER ROOM. ROOMS WILL BE SECURED BY OCCUPANT 1; PLEASE DO NOT FILL OUT A SEPARATE FORM FOR EACH ROOMMATE. AT CHECK-IN, FULL PAYMENT OF GUESTROOM AND MEALS WILL BE REQUIRED FOR THE INTENDED LENGTH OF STAY.

OCCUPANT #1:

Room Type Requested: 2 Queens King
Dietary Requirements: plain/bland with sauces on the side food prepared with seasonings and sauces
Vegetarian?yesno

Arrival Date:		Departure Date:
First Name:		Last Name
Address:

City:

State:

Zip:

Daytime Phone:

Email Address:

Please work out your own roommate arrangements. If a roommate cancels, the remaining occupants are responsible for the total room charges. Please let the hotel know when you register if you have a special request. Roommate & room request cannot be changed after deadline.

OCCUPANT #2:
SPOUSE or Child	Yes No

Dietary Requirements: plain/bland with sauces on the side food prepared with seasonings and sauces Vegetarian?yesno
Arrival Date:		Departure Date:
First Name:		Last Name

Daytime Phone:

OCCUPANT #3:
SPOUSE Or Child	Yes No

Dietary Requirements: plain/bland with sauces on the side food prepared with seasonings and sauces
Vegetarian?yesno

Arrival Date:		Departure Date:
First Name:		Last Name

Daytime Phone:

OCCUPANT #4:
SPOUSE or Child	Yes No

Dietary Requirements: plain/bland with sauces on the side food prepared with seasonings and sauces
Vegetarian?yesno

Arrival Date:		Departure Date:
First Name:		Last Name

Daytime Phone:

Children Meals (dinner-lunch)	10/18- 10/19	10/19- 10/20	10/20 - 10/21	10/21- 10/22	10/22- 10/23	10/23- 10/24	10/24- 10/25	TOTAL MEALS		TOTAL COST
# of Children									X$27

Please Check Lodging Packs ($ amount) Includes room plus 3 meals per day	Single Occupancy $153.68/day	Double Occupancy $103.34/day	Triple Occupancy $86.56/day	Quadruple Occupancy $78.17/day	Rollaway* (When Requested) * $10/day

Year 2 or 3 (room w/dinner 10/18 – lunch 10/25)	$1075.76	$723.38	$605.92	$547.19	$70
* Hotel rooms do not contain refrigerators. If you have a medical need for a refrigerator, contact USHS. TOTAL

Credit Card Information (Important: Full payment for stay will be charged at check-in.)

Credit Card Number: Expiration Date: (00/00)

The lodging package plan is required for all students, assistants, staff and faculty. Meals for children and guests are optional.
No alterations can be made to this plan, and all dates and number of meals are set in advance. Please do not contact the Marriott
Sacramento Rancho Cordova for meal alterations. Please Note: Meal plans for children ages 4-10 staying at the Marriott Sacramento
Rancho Cordova are optional. Children 3 and under are free. Please list all occupants, regardless of age or enrollment in a meal plan.

A deposit of one (1) night’s room and one (1) day’s meals may be charged to your credit card on Monday, September 15, 2008.
There are no cash payments for meal plans. However you may mail a check to: Marriott Sacramento Rancho Cordova,
Attn: Accounting Dept.-USHS, 11211 Point East Drive, Rancho Cordova, CA 95742.

Not lodging at the Marriott Sacramento Rancho Cordova Hotel:
If you attend the USHS and are eligible to lodge off-site, you are required to pay a $15/day Day Use Fee. Please pay this fee
directly to the USHS. You are required to purchase meals if not lodging at the Marriott. Please contact Amina, your program
administrator, for details: 707-965-4102.

Cancellations: Cancellations must be received 72 hours prior to scheduled arrival. Cancellations made less than 72 hours
prior to arrival will be charged one (1) night’s lodging and $53 for one (1) full day of meals.