Hotel Reservation Form

You may complete the first part of this form online and then print, complete and mail or fax directly to the hotel. First night's deposit or credit card guarantee required.

Estancia La Jolla Hotel
9700 North Torrey Pines Road
La Jolla, CA 92037

858-550-1000 (Direct Telephone)
1-877-4-ESTANCIA (Reservations)
858-550-1001 (Fax)

HOTEL RESERVATION DEADLINE: December 28, 2008
If the reservation is not received prior to cut-off date, reservations will be accepted subject to availability.

 

Last Name

First Name

M.I.

Address

City

State

Zip

Country

Telephone

FAX

Email (Please include country and city codes)

Arrival Date

Arrival Time

Departure Date

# in Party

$235 Single* $235 Double*      Smoking Non-Smoking

*per night, plus 12.565% San Diego occupancy tax

Check-in Time: 3:00 pm - Check-out Time: 12:00 Noon

Name on Card__________________________________________________

Credit Card____________________________________________________

Number_______________________________________________________

Exp. Date______________________________________________________

Signature______________________________________________________

 
© 2008 Advanced Nephrology