From: [requiredEmail] 
To: patty@housing.uwo.ca
Bcc: [requiredEmail] 
Subject: Bed & Breakfast Application Form

The following information was sent to Conference Services 
regarding your Bed & Breakfast reservation. Thank you for making a
reservation at Essex Hall.  We look forward to your visit to The
University of Western Ontario.


Surname: [requiredSurname]
Givenname: [requiredFirstname]

Address:
[requiredAddress]

City: [requiredCity]
Province: [requiredProvince]
Postal Code: [requiredPostalCode]

Phone: [requiredPhoneNumber]

Email: [requiredEmail]

Room Assignment Information
---------------------------
[requiredRoomAssignment] 


Gender
[requiredGender]

Roommmates Requested:
1. [roomate1FN] [roomate1LN]
2. [roomate2FN] [roomate2LN]
3. [roomate3FN] [roomate3LN]
4. [roomate4FN] [roomate4LN]


With a group?: [withGroup]

Group Name: [groupName]


Intended Occupancy Period
-------------------------
Date of Arrival: [requiredMonthofArrival]  [requiredDayofArrival]
Date of Departure: [requiredMonthofDeparture]  [requiredDayofDeparture]