Hotel Reservation FORM - 5th TAHI IPv6 Interoperability Test Event

Send the information below to:
	TAHI Accommodation
	c/o Maki Ikegami, e-side, inc.
	register@tahi.org, Fax: 81-3-3585-8162

* Not required if already submitted with Registration Form.

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Name:
__________________________________________________________________________

Email:
__________________________________________________________________________

Company Name:
__________________________________________________________________________

*Tel:					*Fax: 
__________________________________________________________________________

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DESIRED ACCOMMODATION 
Hotel Green Tower Makuhari - available from Jan. 18 (in) through Jan. 24 (out)
Room Rate: 9,500 JPY - one night use of a single room 
(breakfast and service charges included/5% tax not included)
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In:  Jan. _______		Out: Jan. ._______ 		Nights: _______

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*CREDIT CARD INFO (required to guarantee reservation)
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Credit Card:	[  ] VISA	[  ] MasterCard		[  ] AMEX

Cardholder's Name:
__________________________________________________________________________

Card Number:
__________________________________________________________________________

Expiry Date:		MM		YY
__________________________________________________________________________


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PLEASE DO NOT SEND CREDIT CARD INFORMATION BY E-MAIL.
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Notes:   
1. This service provides you with a reservation only. 
    Payment should be made at the hotel front desk on check out. 
    Receipts will be issued by the hotel as required.   

2. Credit card info is required to guarantee your reservation. 
    The card will not be processed unless a cancellation charge applies.   

3. Cancellation charges will be applied as follows:

    Cancellation Notice given:
    a) on or before January 9 - no charge
    b) Jan. 10- Jan. 17 - 5,000 JPY
    c) on the first day of stay (or no notice given) - one night's accommodation (9,500 JPY)