Hotel registration

Madrid, 28th - 30th de abril 2010
ACCOMMODATION AND GALA DINNER FORM
FAMILY NAME
NAME
COMPANY / INSTITUTION
ADDRESS
CITY
POST CODE
TELEPHONE
COUNTRY
E-MAIL
A- GALA DINNER (29th April)
Dinner (100 €)
Yes
B- HOTELS
Nº Persons
No
Double room for single use
Meliá Castilla *****
Capitán Haya, 43
AC Aitana ****
Paseo de la Castellana, 152
AC Cuzco ****
Paseo de la Castellana, 133
Infanta Mercedes ***
Huesca, 21
Gran Atlanta ****
Comandante Zorita, 34
Double room
139,10 €
155,15 €
139,10 €
151,94 €
139,10 €
151,94 €
85,60 €
112,35 €
77,04 €
89,88 €
Hotel rates per room and night, include breakfast and 7% VAT.
ARRIVAL DAY
TOTAL TO PAY A+B
DEPARTURE DAY
This Form should be sent with the amount of one night's accommodation, according to the kind of room and hotel
selected. The amount received will be deducted from your final hotel invoice.
Deadline to guarantee the Hotel Reservation: 22nd March 2010.
Cancellations: All cancellations have to be sent in writing to Siasa Viajes.
1. Cancellations received between 25th March and 15 th April will be refunded.
2. Cancellations received after 16th April will not be refunded.
METHOD OF PAYMENT
· Credit Card
Credit Card number
Visa
American Express
Master Card
Expiry date
Card holder's name
· Bank Transfer to SIASA VIAJES S.A.
Signature
c/c: 0072 0505 18 0000103878 - Banco Pastor.
ES91 0072 0505 18 0000103878 - BIC PSTRESMM
(Please send a copy of the Transfer with the complete name of the
participant to Siasa Viajes)
Send to:
SIASA VIAJES S.A.
Pº de la Habana, 134 - 28036 Madrid
Tel.: +34 91 457 48 91 - Fax: +34 91 458 10 88
E-mail: SB10mad@siasa.es
Print to send by Fax ( + 34 91 458 10 88)
Send by e-mail
All personal data provided will be processed in accordance with the Personal Data Protection Act 15/1999.