081023_Participation form_Edinburgh

Return to: Fax +33
08
Edinburgh 23.– 24.10.
eppf, PANAMA and EPAQ Congress
140 69 52 30
Application Form / Form d’application / Anmeldeformular
Please fill in block letters / Veuillez remplir en lettres capitals / Bitte in Blockschrift ausfüllen!
Participant / Participant / Teilnehmer
Name / Nom / Name:...........................................................................................................
First name / Prénom / Vorname:............................................................................................
Company / Firme / Firma:.....................................................................................................
Position:................................................................................................................................
Address / Adresse / Adresse:..................................................................................................
City, Country / Lieu, Pays / Ort, Land:....................................................................................
Postcode / Code postal / PLZ:................................................................................................
Telephone / Téléphone / Telefon:...........................................................................................
Telefax / Téléfax / Telefax:......................................................................................................
E-Mail:..................................................................................................................................
I confirm my participation as follows / Je confirm ma participation comme suit / Ich bestätige meine Teilnahme an den Veranstaltungen wie folgt:
Wednesday, 22nd October
eppf Technical Committee (for eppf members only)..........................
eppf Economic Committee (for eppf members only).........................
Yes . .......
Yes . .......
No
No
eppf Plenary Assembly (for eppf members only) . ............................
EPAQ General Assembly (for EPAQ members only)..........................
Congress................................................................................
Yes . .......
Yes..........
Yes . .......
No
No
No
Cocktail and Dinner................................................................
I will be accompanied by .............. person
Yes . .......
No
Yes..........
Yes . .......
No
No
Thursday, 23rd October
Friday, 24th October
Participation fee for both days: 190,00 Euro. An invoice will be sent to you with the confirmation.
...........................
Congress................................................................................
PANAMA Int. General Assembly (for PANAMA members only)...........
City, Date / Lieu, Date / Ort, Datum:...................................................................
Company stamp, signature / Signature / Firmenstempel, Unterschrift...........................................................................................
.................................................................................................................................
Hotel Booking
Caledonian Hilton, Princes Street
Edinburgh EH1 2AB
Please return to Caledonian Hilton, Edinburgh to the room reservation office:
Fax +44 131 222 8889
The deadline for making reservations is 15th September 2008.
Dear Sirs, please make the following hotel reservation:
Standard Hilton Guest Rooms:
Single occupancy
Double occupancy
£ 195,00 incl. breakfast from............................to..................... (....... nights)
£ 215,00 incl. breakfast from............................to..................... (....... nights)
This price is per room, per night and includes a Hilton breakfast buffet.
All above mentioned rates are inclusive of VAT.
Arrival date:.........................
Departure date: ..................
Name:.......................................................................................................................
Address: ...................................................................................................................
Phone:.................................
Fax:.....................................
Payment for accommodation should be made directly to the hotel. In order to guarantee your room
please supply the following credit card information.
Without these details we cannot accept and confirm the reservation.
Credit card type:....................................
Number:................................................
Expiry date:............................................
Date:.....................................................
Signature / authorisation: .............................................................................................................