Group accommodation booking form

Group accommodation booking form

Contact details

Given name Your first name
Family name Your surname or last name
Organisation name If applicable
Email Your email address
Telephone Business hours contact number (include country code)
I am a... What is your relationship to the University?	UWA studentUWA staff memberParent of a UWA studentVisitor or guest of the UniversityConference delegateOther
Other

Booking and guest details

Number of guests How many guests will be staying?
Arrival date	12345678910111213141516171819202122232425262728293031JanFebMarAprMayJunJulAugSepOctNovDec2021202220232024202520262027202820292030203120322033203420352036203720382039204020412042204320442045204620472048204920502051205220532054205520562057205820592060206120622063206420652066206720682069207020712072207320742075207620772078207920802081208220832084208520862087208820892090209120922093209420952096209720982099
Departure date	12345678910111213141516171819202122232425262728293031JanFebMarAprMayJunJulAugSepOctNovDec2021202220232024202520262027202820292030203120322033203420352036203720382039204020412042204320442045204620472048204920502051205220532054205520562057205820592060206120622063206420652066206720682069207020712072207320742075207620772078207920802081208220832084208520862087208820892090209120922093209420952096209720982099
Are your dates flexible?	-- Leave Empty --YesNo
Will you require meal services? Select all that are applicable	Breakfast  Lunch  Dinner
Special requirements, requests or general queries