HRM - Hotel Reservation Management, Inc.
875 N. Michigan Ave. Suite 3100
Chicago, IL 60611-1962

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Secure Reservation Request Form

PFS Fast Start School: August 4-5, 2017

Step 1

Please supply us with at least two contact methods (phone, fax, e-mail, etc.) to confirm your request.

To request multiple rooms, you must submit a new form for each room and the name of the guest. 

 

Guest Information

Guest Name: Work Number:
Contact Name: Home Number:
Company: Fax Number:
Address (line 1): Address (line 2):
City: State:
Zip Code: Email Address:
Country: Name of Your RVP:

Step 2
Please supply us with the your arrival and departure dates (which may differ from the event dates), along with the number of beds and persons.

If you have any special request and / or comments, please indicate them below.

Hotel Information

Arrival Date (mm/dd/yyyy):  Departure Date (mm/dd/yyyy): 
one bed or two beds  # of Adults: 
# of Children: 
PFS Fast Start School
Westin Itasca
400 Park Blvd.
Itasca, IL 60143
Hotel phone: 630-773-4000
$99 Single
$199 Suite
Tax rate is 11%
Breakfast is not included

Special Request:

Smoking  Non-Smoking 
High floor  Low floor 
Handicap Accessible Room (please specify in comment section below) 

Please supply any comments regarding this request:

Step 3
Please supply the following credit card information.

Credit Card Information

Credit Card Type :
Credit Card Number :
Expiration Month / Year :     
Credit Card CVV Digits: * Enter the 3 digit (MC/Visa) or 4 digit (AmEx) verification code from your card.
Name on Credit Card :

Step 4

To submit your request, click on the "Place Reservation Request" button below.

To clear this form, click on the "Reset This Form" button.

To request multiple rooms, press the "Place Reservation Request" button and submit a new  form for each room.