Holiday Inn Toronto Bloor-Yorkville 280 Bloor Street West Toronto, Ontario M5S 1V8 Phone: 416-968-0010 Fax: 416-968-7765 WWW.holiday-inn.com/torontomidtownPARTICIPANT IN-HOUSE RESERVATION REQUEST FORMEvent: Indigenizing Psychology SymposiumBooking Code: IPSDate: Wednesday, May 30, 2012 to Friday, June 1, 2012Rate in Canadian Dollars: $129.99 single/double $139.99 triple/quad Plus applicable 13% HST tax, per room, per night Choice of Standard: one Queen bed or two Double bedsRoom rates are available for booking until Monday, April 30, 2012. To avoiddisappointment, please remit this form via email, fax or phone the hotel directly nolater than Monday, April 30, 2012. For reservations, please contact the hotel directly via: E-mail: firstname.lastname@example.org Phone: 416-968-0010 Fax: 416-968-7765Booking Information:Name: __________________________________________________________Mailing Address: _________________________________________________Telephone: _____________________ Fax: ____________________________Arrival Date: _________________ Departure Date: ________________Number of people: ____ Room Type: Non-smk: 1 1 Queen bed 1 2 Double bedsCredit Card Type: Visa Amex Master Card Diners Sears DiscoveryCredit Card Number: ___________________________ Exp Date: ___________Name on Card: _________________________Printed: ______________________________Guaranteed reservations are held until 7am the next morning of the reservation date. If the guest failsto arrive, the guarantor will be charged one nights accommodation as a “NO SHOW”. Individualreservations require 24hrs cancellation notice to avoid this charge.