Step One: General Information
Name of Meeting: *
Contact First Name: *
Contact Last Name: *
Job Title: *
Organization Name: *
Address: *
City: *
State: *
Postal Code: *
Country: *
Phone Number: *
Fax Number:
Email Address: *
Organization Web Address:
Professional Memberships:
Priority Club Number: (Holiday Inn only)
Corporate ID Number: (If applicable)
Response Preference:	Phone Fax Email Postal Mail
Response Due Date	(mm/dd/yyyy)
Decision Date	(mm/dd/yyyy)
Dates Needed:	Arrival Date: (mm/dd/yyyy) Departure Date: (mm/dd/yyyy)
Alternate Dates?	Yes     No
Alternate Dates:	Arrival Date: (mm/dd/yyyy) Departure Date: (mm/dd/yyyy)
Step Two: Lodging Details
Hotel(s) Requested:	Holiday Inn Oceanfront Best Western Flagship Quality Inn Boardwalk
Total Number of Rooms Needed:
Room Breakdown:	Suites: (Holiday Inn Hotel & Suites Only) Singles: Doubles:
Hospitality Suite Needed:	Yes   No Dates: Times:
Special Sleeping Arrangements:
Step Three: Meeting Space Information
Date Start Time End Time Event Type Setup
Audio-Visual Equipment:	Slide Projector Overhead Projector Rear Screen Projector TV Monitors VCR LCD Units Video Camera Microphone Flipchart Markers Easels Other
Other Hotels or Cities being Considered:
Group History: (Please include any previous history for this meeting, if available)
Step Four: Payment Arrangements
Room Block Comments:
Rate Range Requested from:	to
If rate is commissionable, enter IATA or Organization:
Reservation Method:
Other Reservation Method Details:
Reservation Payment Method:
Other Reservation Payment Method Details:
Meeting Payment Method:
Other Meeting Payment Method Details:
Tax Exempt ID: (If applicable)