Hello Guests. To help respond to your requests quickly, please email us at: [email protected] 1. We will need the attached credit card authorization form completed by the name of the person staying in the room. 2. You may also state “PLEASE CALL” on the subject line of your email and our staff will call you. 3. Please include in the email: a. Booking ID: 1999 b. Bed preference e.g., king or 2 doubles c. Dates you are reserving Thank You! One Time Credit Card Payment Authorization Form Sign and complete this form to authorize Twin Arrows Navajo Casino Resort to make a onetime charge to your credit card listed below. By signing this form you give us permission to charge your account for the amount indicated on or after the indicated date. This is permission for a single transaction only, and does not provide authorization for any additional unrelated debits or credits to your account. Please complete the information below: I ____________________________ authorize the Resort to charge my credit card (full name) account indicated below for _____________ on or after ___________________. This payment is for (amount) (date) _____________________________________. (description of goods/services) Billing Address ____________________________ Phone# ________________________ City, State, Zip ____________________________ Email ________________________ Account Type: Visa MasterCard AMEX Discover Cardholder Name _________________________________________________ Account Number _____________________________________________ Expiration Date ____________ CVV2 (3 digit number on back of Visa/MC, 4 digits on front of AMEX) ______ SIGNATURE DATE I authorize the above named business to charge the credit card indicated in this authorization form according to the terms outlined above. This payment authorization is for the goods/services described above, for the amount indicated above only, and is valid for one time use only. I certify that I am an authorized user of this credit card and that I will not dispute the payment with my credit card company; so long as the transaction corresponds to the terms indicated on this form. Native Innovation 2015 Education Technology Conference “Release Your Digital Innovator” June 12-13, 2015 Twin Arrows Navajo Casino Resort Flagstaff, Arizona Conference Registration Form: Please fill out legibly Name of School or Organization: POC (Point of Contact): Address: City: ___________________ State: Phone: Zip: Fax: Email: Conference Registration Fee: All Paid Participants will receive a Chromebook Registration (*Chromebook Included) $399 Per Person Group of 5 or more (*Chromebooks Included) $250 Savings $349 Per Person Group of 10 or more (*Chromebooks Included) $740 Savings (Best Deal) $325 Per Person Vendor Fee Only (Fee includes 2 people, 1-table and 2-chairs) $300 Per Vendor NAME / Title E-Mail Address AMOUNT Method of Payment: Must be attached to registration. Check #__________ Purchase Order #________ TOTAL: $_________ We#do#accept#all#major#credit#cards.#Please#visit#www.nativeinnovation.com#to#process#CC#payments.## # Cancellation#Policy:#Non$refundable-$250-per-person.-Cancellation-request-can-be-emailed-and-must-be-receivedby-May-31,-2015,-no-exceptions.-Substitutions-are-accepted.-Please-fax-(877.511.2342)-or-mail-completedregistration-form-with-payment-or-Purchase-Order-to:-Native#Innovation#Inc,#1750#S.#Railroad#Spring#Blvd#Ste#9,# Flagstaff,#Arizona#86001# #
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