PIERS2007 in Prague

Agentura Carolina, Ltd. - Albertov 3a/7, 128 01 Praha 2, Czech Republic - Tel.: +420 224 990 827 - Fax: +420 224 918 681
Contact person: M. Kocourková, E-Mail: piers2007@carolina.cz, URL: www.carolina.cz

PARTICIPANT

Family name: *

First name: *

Title:

Gender: Male Female

Organization: *

Mail for correspondence: *

HOTEL RESERVATION - DEADLINE: May 31, 2007

Participants should make their reservation directly at Agentura Carolina Ltd. with this form.

LIST OF THE HOTELS

	HOTEL	Single	Double
1.	Hotel DIPLOMAT	$ 173	$ 188
2.	Hotel CROWNE PLAZA	$ 112	$ 137
3.	Hotel PYRAMIDA	$ 93	$ 107
4.	Hotel AVION	$ 102	$ 123
5.	Hotel KAMILA	$ 64	$ 83
6.	Hotel KRYSTAL	$ 50	$ 66
7.	KOMENSKÉHO Dormitory	$ 30	$ 46
8.	MASARYKOVA Dormitory	$ 61	$ 77

I HEREBY BOOK:

Arrival date: *

Approx. arrival time: *

Departure date: *

No. of persons: *

No. of nights: *

In case of accommodation in a double room, please write down the second person's name sharing a double room:

Second person's name: *

For detailed hotel information click here (new window)
Rates are indicated in USD ($), per room, per night and breakfast. Price is final and includes also VAT and local taxes.
Extra hotel services to be paid directly at the hotel reception desk upon check-out.

METHODS OF PAYMENT *

Bank transfer to Agentura Carolina via Bank ČSOB (Československá obchodní banka), Anglicka 20, Prague 2, Czech Republic
Account No. 473474193/0300, VS 7005
IBAN Code: CZ98 0300 0000 0004 7347 4493, BIC: CEKOCZPP
The name of the participant must be clearly indicated on the bank advice. Please note that all bank transfer charges must be borne by participant and may not be deducted from the remitted ammount.

Credit card

Visa Eurocard/MasterCard American Express Diners

Credit Card number:

Expiry date:

Name of Cardholder:

Please note that we are allowed to charge credit cards in Czech crowns only. The amount will be converted by using exchange rate of Czech National Bank valid on the date of payment. There will be a maximum 2 % handling charge.

CANCELLATION CONDITIONS (to be read and undersigned) *

The deadline for sending the hotel form is May 31, 2007. Later orders will be carried out according to the availability and a potential of Agentura Carolina. For accommodation orders please use only contacts stated in the heading to avoid duplicate reservations.

The total amount for the services ordered is required to be paid June 11, 2007 at the latest. The reservation can only be confirmed upon the receipt of the payment. The cancellation received after June 19, 2007 is subject to a cancellation fee of 40 %. The cancellation received after June 25, 2007 is subject to a cancellation fee of 70 %. In case of a cancellation later than July 10, 2007 no refund will be made.

By sending this document I acknowledge that I commit myself to immediate payment and that I have taken note of the cancellation terms.

Date: 15.3.2010

I have read above mentioned payment and cancellation conditions and I accept them accordingly.

If you have different request, please feel free to contact us. We can offer you further hotel exactly on your request.

We look forward to welcoming you to Prague!

PIERS2007

Progress In Electromagnetics Research Symposium

HOTEL BOOKING FORM