Download Accommodation Form

SYMPOSIUM
"Prevertebrate-Vertebrate Transition (Aspects of Vertebrate Origins)"
A Tribute to Berthold Hatschek (1854-1941)
ACCOMMODATION FORM
Please, fill in the Accommodation Form in block letters and return it before April 29, 2005 to
Conference Partners Ltd.
Surname ________________________________First Name________________________________
Title ____________________________________ Institution_________________________________
Mailing Address ___________________________________________________________________
Post Code ____________________ Town_____________________ Country___________________
Phone _______________________ Fax ______________________ E-mail____________________
Arrival :_______________________ Departure :_________________Nights :___________________
I wish to reserve the following accommodation:
HOTEL
SGL ROOM
DBL ROOM
Novotel ****
Bohemia Plaza R. ****
Tchaikovsky ****
Attic ***
150 EUR
110 EUR
99 EUR
70 EUR
165 EUR
130 EUR
119 EUR
90 EUR
NO. OF SGL ROOMS
NO. OF DBL ROOMS
All prices are per room, per one night incl. breakfast, VAT and the city tax.
In case of exchange rate changes by more than 5 % and changes in the Czech VAT law Conference Partners has the right to
modify prices.
Hotel Deposits:
Reservation will be guaranteed only after receipt of the first-night deposit. The rest of the
accommodation payment should be covered on May 15, 2005 at latest.
Cancellation Fees:
All changes or cancellations must be done in writing and sent to Conference Partners. Refunding will
be performed according to the following cancellation fees:
Cancellation within 30 – 15 days prior to arrival: 30 % of booking value
Cancellation within 14 – 07 days prior to arrival: 60 % of booking value
Cancellation within 07 – 0 days prior to arrival: no refunding
TOTAL PAYMENT:
I enclose a copy of the bank transfer in the amount of
Bank account No.: 177010335/0300 of the Conference Partners, at the
Československá obchodní banka, a. s., Anglická 20, 120 00 Prague 2, Czech Republic.
swift code: CEKO-CZ-PP
I authorize the Conference Partners to charge my credit card with the total payment of
 VISA
________EUR
________ EUR
 Eurocard/MasterCard
Card holder‘s name (as appears on card)_________________________________________________________
Card No._________________________________________Expiry date____________________CVCcode*_____
( * CVC code are the three last figures of the number which is above the signature strip on the back side of your card)
Date ________________________________________Signature _____________________________
CONFERENCE PARTNERS Ltd.
Sokolská 26, 120 00 Prague 2, Czech Republic
Org. Ident.No.: 26691621
Tax. Ident. No.: CZ26691621
Phones.: +420 224 262 108 – 110
E-mail: [email protected]
Fax: +4202 224 261 703