registration form

FQAS 2006 – The 7th International Conference on Flexible
Query Answering Systems
June 07-10 2006 – Milano, Italy
HOTEL RESERVATION FORM
Please return within april 30
to : Domm International srl
Fax 0039 02 76000181
Email : telo@domminternational.com
Family name
First name
Company
Address
City
Zip code
Country
Phone
Fax
E-mail
Invoice address (with vat code –for EU countries )
Deposit required
EUR
100,00
HOTEL SELECTION – rates per night per room – continental breakfast and taxes
included
SINGLE
DOUBLE
4 stars
STARHOTEL SPLENDIDO
BEST WESTERN CRISTOFORO COLOMBO
126,00
115,00
138,00
138,00
3 stars
BEST WESTERN CITY
HOTEL NEW YORK
103,00
92,00
150,00
115,00
Check-in date :
Check-out date :
Hotel preference
SPECIAL REQUIREMENTS/REQUESTS
PAYMENT
1)
BANK TRANSFER
Banca Intesa Rete Cariplo – agenzia 11 – Milano – Italy
account number 6152 41722123
ABI code 03069 - CAB code 09471 – CIN code A
IBAN code IT52 A030 6909 4710 0001 2831 11
swift code BCITAIT33111.
Bank transfers are not allowed later than 3 June, 2006
2)
CREDIT CARD VISA or MASTERCARD
CREDIT CARD TYPE AND NUMBER
EXP.
DATE OF BIRTH
CARD HOLDER’S NAME
SIGNATURE
IMPORTANT :
The balance must be paid to Domm International ( not to the hotels )
WITHIN MAY 31,2006
This form is to indicate preference only and submission does not guarantee
confirmation. Notification of confirmed details will be faxed/e-mailed by Domm
International within 7 business days of receipt.
Domm International makes no warranties of any kind that the hotels and rates
listed above will be available at the time you make your reservation. Reservation
requests and changes are subject to the availability and discretion of the hotels.
All information is as of July 2005 and is subject to change.
Fax: +39 02 76000181 – phone : +39 02 7779181
Mail: Domm International srl – Via Rossini 1 – 20122 Milano – Italy
Email : telo@domminternational.com
Cancellation policy: All cancellations must be made through Domm
International
No refunds on room deposits will be given on or after April 30, 2006
In case of cancellation or no show, the chosen hotel will charge to the above
mentioned credit card the total amount for the reserved period. Therefore, I
authorize Domm International to transmit to the chosen hotel my credit card
detail to charge in case of cancellation or no show the total amount for the
reserved period.
Date
Participant signature
Domm International s.r.l. by the Italian law n. 675/1996, decree law June 30
2003 n. 196, informs you that the data will be managed with information
technology, by Domm International - Via Rossini 1 – 20122 Milano, Italy, as
director of the data department, in order to be stored in the databank and used
to send information on the event and to send free of charge documentation about
different events or initiatives carried out by Domm International.
The customer by filling this form agrees to all the above mentioned condition and
therefore to the treatment of personal data.
I AGREE
Date
• yes
• no
Participant signature