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Option 1
Option 2
Option 3
Option 4
Option 5
Contact Name:__________________________________
Organization Name:______________________________
Address:_______________________________________
_______________________________________________
Telephone Number:_______________________________
Fax Number:_____________________________________
E-mail Address:__________________________________
Event/Topic of Meeting:__________________________
Date of Event:___________________________________
Room Assignment: 1 - 2 - 3 - 4
Number Attending:________________________________
Event Start/Finish Time:_________________________
Will food and beverages be served during the meeting/event?
No - Yes
Provided by: ______________________
Bar Service:
Sponsored Bar
Cash Bar
None Requested
Media Services:
Please check equipment requested.All equipment may not be available so please ask for verification.
Podium - Mic/Pa - Screen - Other____________________
Anticipated Charges:
Room Fee: ______________________
Setup/Clean-up: ________________
Security: ______________________
Collateral Deposit: ____________
Bartending Fee: ________________
Media: _________________________
Total: _________________________
Non-refundable Deposit:
50% of Room Fee: ______________________
Remaining Balance:
(To be paid 14 days prior to the event) ______________________
Make Check Payable To: CFM Medical Properties,LLC
***** Late payment could result in the cancellation of the reservation.