ASTRO 55TH ANNUAL MEETING PATIENTS Hope • Guide • Heal Meeting Dates: September 22-25, 2013 • Exhibit Dates: September 22-24, 2013 • Georgia World Congress Center •

FACULTY HOUSING FORM DEADLINE: August 29, 2013 Contact Information (REQUIRED)

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Phone (Please include country and city code for international phone numbers.) Fax ALL HOUSING FORMS MUST BE RECEIVED BY AUGUST 29, 2013. We strongly encourage you to submit your housing form early for best hotel availability. Housing forms received after PAYMENT METHOD August 29, 2013, will be processed on a space-available basis and may be subject to higher rates. Please submit only one (1) form per person. All hotel reservations require a credit card to guarantee your CANCELLATION AND CHANGE POLICY reservation. The credit card must have an expiration date no earlier You may cancel or make changes to your reservation in writing or online until 5:00 p.m. Eastern time on August 29, 2013. than September 2013. Written requests should be sent to the ASTRO Housing Center at [email protected] and will be acknowledged  Check (U.S. dollars drawn on U.S. bank) with an email confi rmation within fi ve (5) business days. To change or cancel a reservation online, you will need your Please make check payable to hotel and mail to ASTRO confi rmation number and the email address that you used to make your reservation. Online requests are acknowledged Housing Center. with an immediate email confi rmation.  Credit Card: If you do not receive your confi rmation, please contact the ASTRO Housing Center to verify that your request has been ____Visa ____MasterCard received and accepted. ____American Express ____Discover Starting September 2, 2013, if you need to change or cancel your reservation, you must call your hotel directly. Cancellations must be made at least 72 Hours prior to your scheduled arrival date or you will be assessed a cancel- Credit card for guarantee only. lation fee equivalent to one night’s room and tax, which will be charged to your credit card. This cancellation policy will be strictly enforced. Please retain the cancellation confi rmation from the ASTRO Housing Center or the cancellation number provided to you by the hotel, as this proof of cancellation will be required to resolve any credit card disputes. CREDIT CARD NUMBER HOTEL PREFERENCE Please rank your top three hotel choices and select your room preferences. Please note that hotel rates may increase if there EXPIRATION DATE is more than one (1) person in a room. Reservation requests made directly with the hotel will not receive ASTRO’s discounted rates. Rates are exclusive of tax and service fees and may change without notice. Refer to the next page for the list of offi cial ASTRO hotels. CARDHOLDER’S NAME (as it appears on card) Hotel accommodations will be made on a fi rst-come, fi rst-served basis. If your preferences are sold out, ASTRO will secure a hotel reservation at a hotel with a room rate similar to those of your hotel preferences. SIGNATURE SELECT ONE (REQUIRED):  Single (1 person/1 bed)  Double (2 people/1 bed)  Double/Double (2 people/2 beds) SELECT ONE (REQUIRED):  Smoking  Nonsmoking BILLING ADDRESS – STREET

Check-in Date Check-out Date Sharing With CITY STATE First Choice Second Choice Third Choice

SPECIAL REQUESTS:  Rollaway Bed (additional fees may apply)  Handicapped Accessible  Triple/Quad Room (additional fees may apply) COUNTRY ZIP CODE  Specifi c Needs______Please note: Most Atlanta hotels comply with the ADA as required by law. ASTRO will not guarantee bed type or special requests. Please confi rm your request with the hotel at check-in. ATTENDEE HOTEL RESERVATION DISCLOSURE By reserving a room at one of ASTRO’s offi cial hotels for the 2013 Annual Meeting, you understand that ASTRO and your assigned hotel(s) have exchanged your personal information for the purpose of facilitating your hotel reservation. You agree to release ASTRO, ASTRO’s offi cial hotels and their respective offi cers, directors, employees and agents from any liability relating to disclosure of your personal information for this purpose. How to Make a Reservation Internet Phone Fax Mail Questions Email www.astro.org/annualmeeting Domestic: 1-800-541-6058 703-631-2971 ASTRO Housing Center Please contact Brittany Ramsey [email protected] International: 703-449-6418 J. Spargo and Associates Inc. at 703-286-1568 or 11208 Waples Mill Road, Suite 112 [email protected]. Fairfax, VA 22030 PATIENTSASTRO 55TH ANNUAL MEETING Hope • Guide • Heal Meeting Dates: September 22-25, 2013 • Exhibit Dates: September 22-24, 2013 Hotel Map

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