Hotel Reservation - Interspeech 2005
Transcrição
Please complete this form and return with payment, no later than July 15th, to : Viagens Abreu S.A., Congress Dept. c/o: Helena Desidério - Av. 25 de Abril, 2 2799-556 Linda-a-Velha Phone:351.21415 61 22 Fax : 351.21415 63 83/4 [email protected] Hotel Reservation 1. PARTICIPANT MR / MRS / MS ___________________ (last Name) FIRST NAME _____________________ INSTITUTION ______________________________________________________________ ADDRESS ________________________CITY ______________COUNTRY_______________ PHONE _______________ TELEFAX_______________ E-MAIL ______________________ 2. ACCOMPANYING PERSON(S) MR / MRS / MS _____________________(Last Name)FIRST NAME ____________________ MR / MRS / MS _____________________(Last Name)FIRST NAME ____________________ 3. Accommodation Please reserve my Accommodation in the following Hotel: 1st Choice Hotel ____________________________________ 2nd Choice Hotel ____________________________________ Single Double Departure ___ /___ / 2005 Total Nights _______ Arrival ___ /___ / 2005 ______ night(s) X ___ room(s) X ________ (A) TOTAL ___________ (We confirm another Hotel if choices are already Fully Booked) 4. METHOD OF PAYMENT Please charge my Credit Card VISA___ MASTERCARD___AMERICAN EXPRESS___DINERS___ Credit card Number ________________________________ Expiry Date ____ / ____ CVV _______ (last 3 numbers on the back side) Owner’s Name ________________________ Address _____________________________________________________________________ Bank Transference to : Î Banco BPI, SA Centro de Empresas Porto In this case, please send us Viagens Abreu S.A. a copy of the Bank Transference Account number :1292463-000-001 Bank Swift BBPIPTPL IBAN nº: PT.50001000001292463000131 BOOKING & PAYMENT CONDITIONS Two nights deposit must accompany this Application Form no later than July 15th The remaining amount must be paid until August 16th 2005. Viagens Abreu will send you confirmation by fax, letter or email. Date : _________________________ Signature : ________________________
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Credit Card Number _____________________________________ Expiry Date_______ / ______ / ______ Owner's name ____________________________ Cvv Code (last 3 digits on the back of the card)________
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A - Payment can be made by BANK TRANSFER as follows: Bank account number or IBAN VIAGENS ABREU, SA Account: 0000000000231320 IBAN - PT50 0033 0000 00000231320 83 NIB - 0033 0000 00000231320 83 Swif...
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Tel: ________________ Fax: __________________ Email: _______________ B – ACCOMMODATION Arrival Date: ___________ Departure Date ___________ Nº of Nights: ______ Nº of Rooms Required: _________ Doub...
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Security code: Please enter the first two digits_________ Send separately the last digit by post, to the address below, or by fax +00351.249.312.068. Adress: Tecnicelpa, Rua Amorim Rosa, N.º 38, 1....
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