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Yamagata International Documentary Film Festival Hotel Reservation Form Please print out this Reservation form, and send it by fax or post.

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	Name:		Sex:
			Age:
	Address:		Phone:
			Fax:
	Company:		Phone:
			Fax:

	Hotel Name:
	Type: [ ] Single / [ ] Twin	Breakfast: [ ] Yes / [ ] No
	* If you prefer to share a Twin room with someone, please write his/her name.

Dates (Please circle you wish to stayin the hotel)

Oct. 9	Oct. 10	Oct. 11	Oct. 12	Oct. 13	Oct. 14	Oct. 15	Oct. 16

Credit Info (Please check one) [ ] VISA / [ ] American Express [ ] Master Card / [ ] Other ( )

Name of the card holder	Card number				Expiration (date/year)
					/

Signature: Deadline: Friday, Sep. 19 Inquiries: JTB for YIDFF 2003 Hotel Reservations 2-17-16 6F Kiba, Koto-ku, Tokyo 135-8505, JAPAN fax: +81-3-5245-8842