Blockade Runner Resort Hotel
Group Reservation Request Form
PO Box 555
Wrightsville Beach, NC 28480
Fax: 910-256-5502   Phone: 800-541-1161
Web site: www.blockade-runner.com
Group No: 8233   Group Name: North Carolina Fall Conference of English Instructors
Name: _____________________________________________
Address: _____________________________________________
  _____________________________________________
Home Phone:_____________________________________________
Business Phone:_____________________________________________
Fax:_____________________________________________
Arrival Date: Sunday, October 28, 2001
Departure Date: Tuesday, October 30, 2001
Your Arrival Date: __________ Your Departure Date:__________
Room:Conference Room Rate Per Night:
___Harbor Deluxe$75.00 per room, per night, plus tax
___Ocean Deluxe$87.00 per room, per night, plus tax
___Ocean Balcony$112.00 per room, per night, plus tax
___Smoking___Non-Smoking
Rooms are assigned as forms are received. If the room type you have requested is no longer available, you will be booked into another room type. Rates include breakfast and are based on single or double occupancy, per night. There is a $25.00 + 9% tax surcharge per night for each additional person in a room. Children under 12 - no charge.
     Check in Time: 3:00 p.m.     Check-out Time: 11:30 a.m.
Name of person you are sharing room with_____________________________________________
Advance deposit of first night's room and tax required
Payment
Method
:
___Check___Money Order___MC___Visa
___AMEX___Carte Blanche___Diners Club___Discover
Card Number:__________________________ Exp. Date:_____
Note: your credit card will be billed for the 1st night's room and tx upon receipt of this reservation form. Cancellation notice required 72 hours prior to arrival date.


Signature_______________________________________________

Please fax completed reservation form to the fax number above.