Kauai Hotel Room Request

Aloha! Please add your name to our priority wait-list. This is not a hotel reservation form. Once rooms become available, we will make every effort to notify and update you on any other options.

Mahalo!

What will be your registration category? *

Name of person attending meeting: *

Name of person to be on hotel reservation (if different):

Number in party *

Number of rooms needed: *

Company

Email Address *

Best phone number (in case email fails)

Ever been to a WSAUA Meeting before? *

Yes

No

Additional Comments

Western Section Member	AUA Member
Allied Health Professional	Exhibitor
Non-AUA Physician	Resident/Fellow
Other (please describe) Other (please describe)