University of Nebraska
Reservation Request Form

Visitors, official guests, staff and faculty that are seeking access to negotiated rates should use this form. Where applicable, University ID, credit card or
authorizing PO may be required at check-in.

Please note this is a request form only, not a confirmation. If space is available, you should receive a notification from the hotel within 24 hours.
If you don’t, or if you need to cancel or amend this reservation, please contact the hotel directly.
Required data is indicated by *  
Nature of Booking: *
Type of Traveler:
University of Nebraska Department (if applicable)
Purpose of Travel:
Traveler Contact Information:  
   Contact E-mail: *
   Contact Telephone: *
   Contact Fax:
Travelers *  
   Traveler 1:
   Traveler 2:
   Traveler 3:
   Traveler 4:
Preferred Hotel:
Restate Preferred Hotel:
(for purposes of emailing)
Traveler Information  
   Arrival Date: *
   Departure Date: *
   Length of Stay - Number of Nights:
   Number of Rooms:
   # of People per Room:
   Nightly Rate:
   Estimated Total:
   Smoking/Non Smoking:
   Room Type:

Hotel services paid by University funds:

  

     Yes No Checking yes indicates that University of Nebraska

  

is paying except for the incidentals.

  
Form of Payment:
University Sponsor Information  
This section is to be completed only when the accommodations
are being paid for by University of Nebraska!		  
University of Nebraska will not accept responsibility for payment of
any reservation that has not been approved by the sponsoring
department prior to stay.		  
Sponsoring Department:
Department Contact Name:
Department Contact Email:
Department Contact Phone:
Department Contact Fax:
Comments:
Special Requests:
Please send comments, questions and/or suggestions to:    larry@campustravel.com