docLadies Program Reservation Form PALMA de Mallorca, May 23
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Ladies Program Reservation Form PALMA de Mallorca, May 23
Departamento de Grupos, Congressos e Incentivos PLEASE RETURN THIS REGISTRATION FORM DIRECTLY TO GEOSTAR BEFORE 1st APRIL 2011 E-mail: [email protected] Fax number : 00.351.22.204.63.56 Att. Mariana Gonçalves ESTA conference from 22th to 24th May 20101 Ladies Program Reservation Form PALMA de Mallorca, May 23, 2011 First Name: _____________________________________________________________ Last Name: _____________________________________________________________ I will participate in the: Full day Palma with lunch € 85,00 YES* NO* (*) Please tick the appropriate response. Direct payment by the Guest to Geostar upon reservation Credit Card details: Visa Mastercard American Express Credit Card holder: ..……............................................................................................................. CVV (Security code): ...................... Credit Card Nr: ........................................……………………………………………….................................. Expiry date: ………/……… Bank Details for Bank transfers: BPI – Banco Português de Investimento, Rua Tenente Valadim, 284. 4100-476 Porto - Portugal Account Number: 7-7994030-000-001 NIB: 0010 0000 7994 0300 00167 SWIFT: BBPIPTPL IBAN: PT 50 0010 0000 7994 0300 00167 Terms of Cancellations and No Show: NO REFUND Date : ……/………/............. Signature : ……………………………..... GeoStar – Viagens e Turismo, S.A. Av. dos Aliados, 210 | 4000-065 Porto – Portugal | Tel.: 22 204 63 55 | Fax: 22 204 63 56 | E-mail: [email protected]@geostar.pt Sede Social: Av. Duque de Loulé, 24 – 2º | 1050-090 Lisboa | Capital Social EUR 2.500.000 | CRC Lisboa | NIPC 500 886 113 | Alvará Nº 315/79
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