Room Reservation Request Form

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					                                                           Room Reservation Request Form
                                              “Latest Advances in Fetal & Neonatal Surgery”
                                        The Chinese University of Hong Kong - Department of Surgery
                                                           November 22-24, 2006

Attention : Ms. Iris Lam, Assistant Sales Manager                              Tel : (852) 2268 7000 Fax : (852) 2739 9315
            “The Salisbury” - YMCA of Hong Kong                                E-mail:
            41 Salisbury Road, Tsimshatsui, Hong Kong                          Web site :

The following special discounted room rates are offer to the above seminar delegates only :

Room Types : Size of room is around 250 square feet. Size of Suite is around 530 square feet. (Please                       box)

 Standard Room                         □    HK$700 for single occupancy        □HK$800 for double occupancy
 Partial Harbour View Room             □    HK$800 for single occupancy        □HK$900 for double occupancy
 Harbour View Room                     □    HK$900 for single occupancy        □HK$1000 for double occupancy
 Family Suite                          □    HK$1400 for a family of maximum 2 adults and 2 small children

Complimentary amenities : Welcome fruit, use of indoor swimming pools/Jacuzzi, Daily newspaper (South China Morning Post)

Guest Name(s)          :             __________________________________________________________________
                                      Surname                First name (please print)

Telephone No.          :              ____________________                Fax No. / Email               : _____________________

No. of Rooms           :             ____________________                 No. of Persons                : _____________________

Arrival Date/ Flight :               ____________________                 Departure Date/Flight :               _____________________

Guaranteed by          :             □ Visa       □ Master □ A.E. □ Diners □ JCB

Cardholder’s name :                 _____________________                 Card number                   :       _________________________

Expiry date            :            ______________________                 Signature                    :       _________________________

Notes : 1. Please reserve your room requirement 45 days prior to the Seminar, otherwise, confirmation of room space and room types
            will be subject to availability upon request.
        2. Please reserve your room by e-mail, telephone or complete and return this form to our hotel.
        3. Above room rates are subject to 10% service charge per night, room tax is not required.
        3. One night room charge will be applied for cancellation less than 72 hours prior to arrival date.
        4. Check-in time is after 14:00 hours and check-out time is at or before 12:00 noon.

 Breakfast requirement (Optional) (Please box)
 Coupons will be issued upon guests’ check in and non-refundable. Advanced booking is required.
 Buffet breakfast discounted at HK$99 nett per person (per breakfast)            □
 Venue : 4/F Salisbury Dining room. Serving time : 7am – 10:30 am
 Simple American Breakfast discounted at HK$50 nett per person (per breakfast) □
 Venue : G/F Mall Café. Serving time : 7am-11:00 am (self service style)

 Transportation (Optional) (Please box) :                     □ Yes              □ No
 Airport hotelink at HK$130 per person per trip. Please approach A1 or B1 counter at arrival hall of The Hong Kong
 International Airport, opposite to Exit A or Exit B for boarding.

                                                      ROOM BOOKING CONFIRMATION                                          (FOR HOTEL USE)
                                           (We will contact you through e-mail if e-mail address is provided)

Your room booking request has been confirmed according to the above request. Have a pleasant trip to Hong Kong.
 Confirmed By :

 Name : ___________________________                                       Date : __________________________

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