Reservationform for guests of the University Bremen

Reservationform for guests of
the University Bremen
Please use this form only after reservation by phone or email.
Registration for
 Gästehaus Teerhof
 Gästehaus Lise-Meitner-Str.
Auf dem Teerhof 58
Lise-Meitner-Str. 5
Personal data
Mrs.  / Mr.  / Prof.  / Dr. ........ 
Surname....................................................................................... First name ..............................................................
Home address ...............................................................................................................................................................
EMail: ........................................................................................... Phone/Fax ..............................................................
Which room has been reserved? Number ______
The guest speaks
Does the guest bring a partner or children? Partner  yes  no
 German
 English
Child(ren)  yes, _____  no
Period of stay (mm/dd/yyyy) from ____________________ to ____________________
Does the guest pay by her-/himself?  yes  no
If not, please give us name of the project or institution and the university digit-code.
Invoice adressed to:
_____________________________________________________________________________________
_____________________________________________________________________________________
8 digit-code for accounts of the Univ. Bremen
Important, fill out strictly!
Who invited the guest ?
Please give the name of the institute, the responsible person for the project and the telephone-number; if known
also name & telephone-number of the secretary
________________________________________________________________________
________________________________________________________________________
I agree with the conditions of the rental agreement at the guesthouse of the University of Bremen and confirm that
my stay is job-related and for offical purposes only (see www.gaestehaus.uni-bremen.de).
__________________________________
Date and place,
signature
Please do NOT write below this line
Raum für interne Vermerke :
Peter Schmeling (Gästehaus, Verwaltung)
Tel. (0421) 95938-67 Fax: (0421) 95938-68
E-mail: [email protected]
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