Indian Head Reservation Form 
May 4, 5, 6, 2012

Please fill in all the information.  Queen Susan needs it all to make your arrival and stay run smoothly.

Name:________________________________________________

Address:__________________________________________________
City, State, Zip
___________________________________________________________

Red Hat Chapter Name:________________________________________

___________________________________________________________
E-mail address:
____________________________________________________________

Phone # with area code:______________________________________

Roommate of choice:__________________________________________

____________________________________________________________

Handicap?  YES_________  NO____________

Other considerations?______________________________________________

___________________________________________________________

__________________________________________________________

__________________________________________________________

Queen Susan will try to honor all your special requests, but cannot guarantee the hotel will follow up on all requests. Most attendees find the management extremely helpful and pleasant.

Send this form with your checks for room choice to:   Susan Olsen
279 Trull Rd
Tewksbury MA 01876
Checks made out to Susan Olsen.
Non-refundable deposit of $50 due by Oct30, 2011;
remainder due by March 15, 2012.

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