REQUIRED HOTEL
INFORMATION:
Check Appropriate Spaces
Complete the Blanks
Grand Lodge Convention
July 16th — 19th, 2017
Peppermill Hotel, 2707 S. Virginia St.
Reno, NV 89502
DELEGATE
MEALS/HOUSING FORM
Name ________________________________________Lodge #_______Membership ___________
Address _______________________________________________Phone #____________________
City ____________________________________________State __________ ZIP ______________
Office/Position:_____________________Spouse Name:_________________(If attending with you)
WILL ATTEND:
Prime Rib__________________Grilled Salmon w/dill Hollandaise___________
$45.00
$_________
Room Deposit (REQUIRED for any room, except DD-Designates) ................................. $136.09
$__________
RESERVATIONS:
CONVENTION ACTIVITIES:
EXALTED RULERS ONLY (PER LODGE) ............. ($225.00 At State Office by 3/24) .... $275.00
$__________
OR
TOTAL SUBMITTED WITH REGISTRATION:
$_______
Mail Form to: WASHINGTON STATE ELKS, PO Box 110760, Tacoma, WA 98411-0760
DEADLINE: March 24th, 2017
(In the hands of the State Office, not postmarked)
Confirmation will be mailed to you within 7 working days of receipt. PLEASE call if discrepancy exists.
ROOM RATE:
$136.09 per night
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Limited # of Smoking
Rooms and Double Queen
Rooms available
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TYPE OF BED:
One King
Double Queen
Smoking
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ARRIVAL DATE:
________________________
(Do NOT leave Blank! ! !)
DEPARTURE DATE:
________________________
(Do NOT leave Blank ! ! !)
(Check in Time: 3:00 PM)
(Check out Time: 12:00 PM)
==================
Special Requirement:
_______________________
DEADLINE - March 24, 2017 (Payment in the hands of the State Office)
MEALS/HOUSING FORM INSTRUCTIONS
Please follow these instructions carefully!
Fill in all information completely and clearly.
All requests for rooms must be submitted on THIS form and must be accompanied by the required deposit for
each room required. Room Rate is $136.09 Single/Double occupancy per night, tax included. DO NOT
SEND the entire amount of your housing, send ONLY the deposit. The deposit will be applied directly to
your hotel bill. Deposit refunds will be based upon the policy of the hotel. ALL housing will be assigned in
the order in which the requests are received. Indicate any special room requirements you may have, i.e.
handicapped access, etc. (Please note, DD-Designates do not pay the first night Lodging. This will be paid
by Grand Lodge.)
CONVENTION ACTIVITIES
Each Lodge is required to pay a fee of $275.00 to defray the costs associated with the Grand Lodge Convention. If your payment is In the hands of the State Office BY MARCH 24TH, 2017 then we will reduced
to fee to $225.00.
Mail Check and Form to:
Washington State Elks Association
PO Box 110760
Tacoma, WA 98411