Meeting and Conference Form

Meetings and Conferences

Request for Meeting or Conference Room Proposal

Company / Name in Full :

Street Address:

Province :

Phone Number :

Contact name :

City :

Postal Code :

Fax Number :

Email Address :

Type of Meeting

Annual

Semi Annunal

Board Meeting

Executive

Sales

Training

Commitee

Other

other :

Dates for meetings.

First Day :

Last Day :

Guest Room Requirements

Number of guest rooms needed per night :

Meeting Room Preferences

Size of space required in ft. : Number of Attendees

Other :

Breakout Room

Largest breakout required in ft :

Number of breakouts required :

Other :

Meals Required

Breakfast	Lunch	Dinner

	Coffee Service A M	Coffee Service P M

Additional Information

Submit request

Please make sure that you have entered in all of the information above so that the correct rate can be determined.

Thank-you for taking the time to complete this form in detail. We will telephone or e-mail you to confirm receipt of this request.

Viscount Gort Hotel
1670 Portage Avenue Winnipeg, Manitoba, Canada
Phone: 204.775.0451 Fax: 204.772.2161
Reservations 800.665.1122