Hotel reservation form

International Symposium
Optical Analysis of Biomolecular Machines
July 13 - 16, 2006
Max Delbrück Center for Molecular Medicine, Berlin, Germany
Hotel reservation form – deadline
MDC
Symposium
May 15, 2006!
Please send by fax or Email to:
DER Deutsches Reisebüro GmbH & Co. OHG
Annemarie van der Hoff
Theodor-Heuss-Platz 2
14052 Berlin
Tel.: +49-30-3025002
Fax.: +49-30-3019768
annemarie.vanderhoff@der.de
Please reserve:
number of rooms:
single room, comfort/standard O
double bed room
O
single room
double bed room
O
O
single room
double bed room
O
O
single room
double bed room
O
O
single room
double bed room
O
O
single room
double bed room
O
O
Maritim Pro Arte
€ 145, --/165, -€ 155, --/175, -Victor’s Residenz
€ 99, -€ 120, -Holiday Inn Humboldtpark
€ 99, -€ 115, -IBIS Reinickendorf
€ 70, -€ 80, -Hotel Bel Air
€ 67, -€ 82, -Business Hotel
€ 50, -€ 70, --
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Last name:_______________________________First name:_____________________
Full address:
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____________________________________________________________________
Phone/Fax:__________________________________________________________
Email:______________________________________________________________
Arrival day:_____________________Departure day:____________ No of nights:_________
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Payment by Credit Card
O Visacard
O Diners
O Eurocard/Mastercard O American Express
No.:_____________________________________________________________
exp.date: _______________2.......……Card Verification Code.........…...…...
Name of the cardholder:____________________________________________________
In case you prefer to pay by cheque please send a deposit of Euro 50,-- (please not in cash!)
with the booking. (You can book by fax or Email and send the deposit separately by mail.) If you prefer
to pay by bank transfer we will send you an invoice. For all payments by cheque or bank
transfer the travel agency will charge Euro 20,-- handling fee.
The deadline for hotel reservations is May 15, 2006. Rooms will be reserved on a first
come – first served basis. In case the preferred hotel is fully booked, reservation will be
made in another hotel in the same price category. All rates quoted are per room/night and
incl. breakfast, service and 16% VAT.
Date:____________________Signature:_________________________________________
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