3 D • D E S T I N A T I O N S

Please provide as much of the following information as possible.

Direct or Travel Company:



First Name:

Last Name:

Company Name:

Address 1:

Address 2:

City:

State:		Zip Code:

Phone Number:

Fax Number:

E-mail Address:

Name of Group/Event:



Preferred Date(s) (month and year):



Preferred Destination(s):



Number of nights: Number of rooms/night:

Meeting/Function Space Required:



Budget per person(USD):



History for this program:



Who is the decision maker: