8/2/2019 February Hotel Form

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February 10 - 12, 2012FFCCHA Quarterly Meeting Hotel Application

Best Western Hotel3701 S W 38th Ave. Ocala, FL (off 1-75 exit 350 go west)

Hotel reservations are for one or two (2) nights (Friday evening February 10 and/or Saturday evening,February 11 while you are attending the FFCCHA Full Board meeting and/or training at the University Center(building 41) on the College Central Florida campus (exit 350, go east). To qualify for hotel room reservations:

1. Recipients must: be a FFCCHA member2. Attend the State Full Board Meeting on February 11, 20123. Completed form must be received no later than January 30, 20124. The money that is due must accompany this form or the application will not be accepted.

Hotel reservations must be made by FFCCHA! Room reservations will NOT be made without the proper formand the money submitted.

Hotel Reservations for February 10  – 11, 2012For options 1 and 3, there will be two (2) people per room. If you do not designate a roommate, one will beassigned. All considerations will be taken in order to meet your request.

(Check all that apply) Option 1 ____ (Two people to a room)

Using the scholarship, each person will only pay $65.00 to stay two nights at the hotel. Option 2 ____ (single Occupancy or Family Room) Using the scholarship, you will pay $130.00 to stay two nights at the hotel.

Option 3 ____ (Two people to a room) for ONE night only  – check: Fri 2-10-12 ___ or Sat 2-11-12 ___ Each person will only pay $37.50 to stay ONE night at the hotel.

Option 4 ____ (Single Occupancy or Family Room) for ONE night only - check: Fri 2-10-12 ___ or Sat 2-11-12 ____ You will pay $65.00 to stay ONE night at the hotel.

Your Name: _____________________________ Roommate Name: ___________________________ 

Email: __________________________________ Email: _____________________________________ 

Please Read The Following Statement ------ Sign & Date!I, the undersigned, do hereby state: the above information is correct to the best of my understanding. Iunderstand that these rooms are being paid for with FFCCHA, Inc. money. Friends and family members mayNOT use this room, unless I have chosen option # 2 or # 4. I understand that I will be assigned a roommate. Iunderstand if I do not attend the Full Board meeting. I will be responsible for the full cost of my hotel room. Iunderstand my reservations will be voided if I do not abide by the guidelines of this contract.

Signature: __________________________________________________ Date: __________________  

Please make money order or check payable to: FFCCHA, Inc.Returned checks will be assessed a $47 fee. NO REFUNDS. Mail to: FFCCHA

9207 Edgemont LaneBoca Raton, Florida 33434

Any questions, please contact: FFCCHA (954) 581-1192 or info@familychildcare.orgOnly completed forms with payment will be accepted and all deadlines will be strictly adhered to! 

If you need an accommodation because of a disability in order to participate in the child care training process, contact

FFCCHA at least two weeks prior to the first training date at (954) 581-1192 between the hours of 8:00a.m – 5:00 p.m.Monday through Friday. Completed forms will be dated as received, in case we exceed the allotted amount of FFCCHAroom block. All providers will be notified by February 6, 2012 of their acceptance. Confirmation of your hotelreservations and scholarships will be provided by e-mail address, please print your e-mail address clearly.

For Office Only: Date Rec'd Check # Cash Money Order Amount $ Scholarship: Approved / Denied