Registration and hotel reservation form

REGISTRATION AND HOTEL RESERVATION FORM

Family name _______________________________________________________________________

First name _________________________________________________________________________

Sex F /_/ M /_/

Institution__________________________________________________________________________

_________________________________________________________________________________

Address___________________________________________________________________________

__________________________________________________________________________________

City______________________________________________ZIP Code________________________

Country___________________________________________________________________________

Phone___________________________________FAX______________________________________

E-mail____________________________________________________________________________

We offer to the participants two different accommodation packages according to the hotel category.
These packages include:

Conference material and abstract book
Hotel accommodation and breakfast for the three days of the meeting
Three lunches in the meeting site (Villa Mondragone)
Two dinners in the hotel restaurant
Coffee breaks
Social dinner
Transportation from/to hotels to the conference site.

ACCOMMODATION PACKAGES:

PERIOD

Arrival: July 30 Departure: August 2 (3 nights)

HOTEL PREFERENCE and PRICES (VAT included)

**** Hotel VILLA VECCHIA
	Single room	1.100.000 ITL
	Double room used as single	1.200.000 ITL
	Double room	930.000 ITL (per person)
	Triple room	900.000 ITL (per person)
	Accompanying person*	600.000 ITL (per person)

*** Hotel GIOVANNELLA
	Double room used as single	840.000 ITL
	Double room	720.000 ITL (per person)
	Triple room	660.000 ITL (per person)
	Accompanying person*	400.000 ITL (per person)

*including hotel accommodation in double room for three nights, three breakfasts, two dinners in hotel and social dinner

Rooms will be assigned according to your preference in the order the forms are received by the Secretariat. Hotel reservation will not be processed without the payment of the chosen package.
We recommend that you make your reservation before May 15, 2001. After this date the Secretariat will no longer be able to guarantee room availability. You will receive the confirmation of your reservation.

REGISTRATION WITHOUT ACCOMMODATION

For people who do not need a hotel room. This package includes:

Conference material and abstract book
Three lunches in the meeting site (Villa Mondragone)
Coffee breaks
Social dinner

Fee: 400.000 ITL

PAYMENT

	by check no_______________of the Bank________________________________________ for ITL _______________________________ (made payable to: Isabella Colace - CIAK)

	by bank transfer payable to: COLACE Isabella - CIAK C/C 2988 ABI 1005 CAB 03231 Branch 63 of the Banca Nazionale del Lavoro Viale Parioli 9, 00197 Rome, Italy

FISCAL DATA FOR THE INVOICE

Invoice heading ____________________________________________________________________

Address:__________________________________________________________________________

City__________________ZIP Code___________________Country__________________________

VAT No. __________________________________________________________________________

CANCELLATIONS

All requests for cancellation and reimbursement must be made in-writing to the Secretariat (CIAK Selezione Immagine srl). There will be no penalties till June 30. After this date penalties will be applied according to the hotels' rules.

I have read and accept all the conditions shown in this form.

According to the law N. 675/96 of the Italian Republic, we wish to inform you that the personal data provided in this form will be used by CIAK Selezione Immagine s.r.l. and by the Organizers of this event exclusively for matters concerning it.

Date ________________________ Signature ____________________________________________