Reservation Form – DSP for Communication Systems

Guest Name:_______________________________________________________________________________

Number of Adults:___________  Number of children:____________
(Please note maximum of 2 adults, 2 Children per room.  Bedding configuration consists of a Queen size bed and pull out double sofa bed)

Address:____________________________________________City/Town:_____________________________

City/Town:____________________  State:____________ Post code:__________Country:________________

Email address: ____________________________________________________________________________

Arrival date: ____/____/____  Departure date:___/___/___ Number of nights:_________ 

Accommodation rates:
	Published Rates	Conference single
rate including full 
buffet breakfast
(1 person)	Conference
Twin / double rate
including full buffet
breakfast (2 people)		
Deluxe Suite	$225.00	$175.00	$195.00	Per room per night	
Penthouse Suite	$285.00	$215.00	$235.00	Per room per night	

Suite required (please tick box):		Deluxe suite 		Penthouse suite  

You will be required to pay a deposit equal to 1 night’s accommodation to guarantee bookings.  A 2 night minimum applies.  In the event of cancellation, $90.00 of the deposit is non – refundable and full deposit is non- refundable if the reservation is cancelled within 14 days prior to arrival.

Payment Method (please tick box):	Cheque		Bank Transfer		Credit card

Credit card:  4.5% surcharge applies to AMEX/DINERS card holders (please tick box)

AMEX	 	Diners		Master 		Visa 		Bank card 

Credit card number:______________________________________________________________

Card Holders name:_____________________________________ Expiry date:____/____/______

Card Holders signature:___________________________________________________________

Bank Transfer details:  	National Australia Bank
				BSB:  084 855
				Account number:  525 646 314

Special requirement:__________________________________________________________________________

Please fax / email / post back this Reservation form to Noosa Blue Resort