Please fill out all fields of this form to the best of your knowledge. If you should have any problems or questions filling out this form, please contact the Coordinator at 314.516.4399. All requests made within 24 hours of arrival will be subject to a $10 per night rate increase. Please also note that this is not an automated system, you will need to allow up to 48 hours for a response.  If you reserving rooms for multiple people, you must submit one form per person.

Fields denoted with an asterisk (*) are required

*Guest's Name:
*Arrival Date (MM/DD/YR):
*Arrival Time (AM or PM):

Arriving by:

Vehicle
Air

*Departure Date (MM/DD/YR):
*Departure Time (AM or PM):
Please fill in the number of the type(s) of rooms requested:
Single-Male
Single-Female
*Mailing Address:
*City:
*State:
*Zip Code:
*Daytime Phone:
*Evening/Mobile Phone:
*E-Mail Address:
FAX:

Payment by:

Self
University of Missouri-St. Louis Department

University of Missouri-
St. Louis Department
(Please include MoCode):

Are you attending or associated with a conference group or interning for a company?
If so, please list the conference/company below so we may place you near other participants/interns.

If none, please type in none.

Will you be bringing your own bed and bath linens or
Will you need Guest Housing to provide them for you?

*All mattresses are XL Twin.

Please provide the following item(s) for my stay:

Will you need to park a vehicle on campus?
*Parking is charged at the rate of $1 per day.

Yes
No

Would you like the phone and data ports activated during your or your guest's stay?

*Please note that the charge is an additional $12.50/week (there is no daily rate and the ports are bundled).

Yes
No

Will you need a guest wireless account created for you during your stay? (There is no charge.)

Yes
No