SURA Residence Facility Reservation Request

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All reservations are subject to availability and the information provided should be for the guest room occupant(s). If reservations are being made for someone other than the occupant(s), your name and contact information is required and should be noted in the Additional Information section of this form.

If an availability response or reservation confirmation is not received within one business day, please contact our office at resfac@sura.org.

All fields are required or reservation confirmation will be delayed.

First and Last Name *

E-mail Address *

Home Institution *

Phone Number *

Jefferson Lab Campus Access *

Yes

US Citizen

Foreign National

Registration Approval Received

If you have selected YES regarding registration approval, please enter the approval start and end dates below. If you have selected NO notate “Pending”. Please note ALL registrations will be confirmed with Jefferson Lab and reservation confirmations will only be sent upon approval. Room holds will be released 72 hours prior to arrival if registration has not been approved. *

Check In Date *

YYYY

Check Out Date *

YYYY

Purpose of Visit *

Event

Experiment

Other

Explain purpose of visit to include event name, Hall affiliation for experiment, or other as applicable. *

Type of Visitor *

User - Non Student

Student

Event Attendee

Other

If other selected please explain:

JLAB Sponsor *

Number of Persons *

Adults

Children

Type of Room (based on availability)

King Bed

One Double Bed (Full)

Two Twin Beds

No preference

Clear selection

Special Request

Parking at the Residence Facility is permitted for registered guests and visitors only. A permit is required and detailed vehicle information may be requested upon arrival.

Please select an option below if you will need a vehicle permit.

YES

Payment Options *

Credit Card on file : Select this option if you have been stayed at the facility within the past year and your information is on file and up to date.

Credit Card Guarantee Form Needed: A reservation guarantee form will be sent to the email of the guest room occupant. If someone other than the occupant is paying for this stay by credit card, provide the name, and contact information for the responsible party in the additional information section of this form.

Home Institution Direct Billing: Select this option if the reservation will be invoiced to the occupant’s home university. Please provide the institution, purchase order and/or grant number in the additional information section of this form.

Jefferson Lab Direct Billing: Select this option ONLY if you are an authorized travel coordinator at the Jefferson Lab. Please provide your name and trip authorization number in the additional information section of this form.

Additional Information:

Submit

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