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					                                              ACCOMMODATION REQUEST FORM
                                                   2012 CellML Workshop
                                                           12 March 2012 – 13 March 2012


CONTACT DETAILS: Please complete and e-mail to uoa@apx.co.nz or Call                   +64 9 3753999 for more information

PREFERRED TITLE:              Mr / Mrs / Miss / Ms / Dr / Assoc Prof / Prof / Other                      GENDER:                    MALE / FEMALE

NAME/S OF GUEST/S:

TELEPHONE:                    + (     )                            MOBILE:       + (       )                          FAX:          + (        )

STREET ADDRESS                                                                                        EMAIL:                          @

ARRIVAL DATE:                                          /           / 20                DEPARTURE DATE:                                     /          / 20

ARRIVAL TIME:                                          :           AM / PM             DEPARTURE TIME::                                    :          AM / PM

NUMBER OF NIGHTS:


ACCOMMODATION PREFERENCE:


LANGHAM HOTEL                                                         THE PULLMAN 

83 Symonds St, Auckland City                                               Corner Princes Street & Waterloo Quadrant, Auckland City

Classic room $184 a night                                                  Superior Room $175 a night

Executive room $230 a night                                                Superior Residence $210 a night



QUADRANT HOTEL                                                         COPTHORNE AUCKLAND CITY 

10 Waterloo Quadrant, Auckland City                                        150 Anzac Avenue, Auckland City Auckland City

Studio Room $133 a night                                                   Standard room $113 night

1 bedroom Apartment $156 a night


QUEST on Cintra 1/2                                                     COPTHORNE HARBOUR CITY 

3 Whittaker Place, Auckland City                                           196-200 Quay Street,, Auckland City

1 Bedroom Apartment $140 a night                                           Standard room $132 night

                                                                           Superior Room $158 a night



email: uoa@apx.co.nz or call +64 9 3753999 for more information

Conditions of Reservation:
All bookings and pricing are subject to availability at time of booking. Pre-booking is essential. Credit card details are required to confirm the reservation. We
recommend booking an extra night should you require an early check-in or late departure. All hotel bookings are subject to the individual hotel’s terms and
conditions.

CREDIT CARD AUTHORISATION FOR DEPOSIT:
I ……………………….hereby authorise APX to use the following credit card details to confirm my preference as above:

NAME ON CARD:

CARD NUMBER:

TYPE OF CARD:                               VISA / MASTERCARD / AMERICAN EXPRESS                                              (CIRCLE ONE)

EXPIRY DATE:                                           /20                            SECURITY NUMBER:

CARDHOLDER SIGNATURE:

				
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