IEEE International High Level Design Validation and Test Workshop 2004 (HLDVT'04)
Hotel Registration Form

Mail or fax this form to:

The Lodge at Sonoma 1325 Broadway, Sonoma, CA 95476 Phone: 707-935-6600/888-710-8008 Fax: 707-935-6829 Website: www.thelodgeatsonoma.com

Hotel cancellation policy is 24 hours prior to arrival

First Name __________________________Last Name______________________________________________________________

Company ________________________________

Mail Stop ______________________Street Address ___________________________________________________________________

City __________State ________Zip ______

Country ________________________________________________________________

Phone __________________________________Fax ________________________________

Hotel rates - single................ $150.00 double................ $150.00

Arrival Date ______________________Departure Date ____________________

Your reservation can be guaranteed by credit card. Your credit card will be billed for first night’s deposit.

Check_____ Visa_____ Mastercard_____ American Express_______________

Card #__________________________________________________Exp. date__________