Reservation Form for Cambrad Lodge Motel

Bruce Highway

Phone: +61 (7) 4926 8500; Fax: +61 (7) 4926 7724

Email: info@cambradlodgemotel.com.au

IⁿSITE 2004
Informing Science + IT Education Conference
June 25^th – 28^th 2004

sponsored by the
Central Queensland University, Faculty of Informatics and Communication

 Conference organized by the Informing Science Institute
Eli Cohen and Elizabeth Boyd, Organizers@InSITE.nu

NAME of Delegate(s):_____________________________________________________________

ADDRESS:______________________________________________________________________

________________________________________________ POSTAL CODE:  ________________

TELEPHONE: _______________________ FAX:___________________________

EMAIL: ___________________________________________________________

ROOM TYPE: PLEASE TICK

SINGLE, DOUBLE, or TWIN_________@ 80 AUD/night
FAMILY _________________________@ 115 AUD/night (2 adults + 2 children)

[These discount conference rates are guaranteed only until April 15, 2004]

DATE of ARRIVAL: _____________ DATE of DEPARTURE: ________________

NUMBER OF NIGHTS: _______ @ $____________per night  =  _______________

Payment details: (Please circle)     Cheque   Money order   Credit Card

CREDIT CARD NUMBER: ____________________________________________

Expiration Date of Card (MM/YY) ______   Name of card holder ________________________

__________________________________________________________________________

Signature of card holder Date

I will notify the hotel the day before I am scheduled to arrive should I need to change my plans. Otherwise the hotel will hold my room for my arrival and charge my credit card for that night.

Please fax completed form to
Cambrad Lodge Motel
by 15^th April 2004
Fax number +61 (7) 4926 7724