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6th Congress of the European Society for Analytical Cellular Pathology Heidelberg, Apr.7-11, 1999 |
Name: ___________________________________
First Name: ______________________
Title:_________________
Institution/Company:
_____________________________________________________________________________
Street: ________________________________
ZIP Code: _______________
City:____________________________
Country: _________________________
Phone:(+country/area code) __________________
Fax:__________________
E-mail _________________________________________________
1. Hotel Reservation: (Please indicate number of required rooms in appropriate line position)
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Single room: (incl.breakfast) |
Double room: (incl.breakfast) |
No rooms in category: |
|
____ DM 285/330 ____ DM 190/240 ____ DM 160/190 ____ DM 120/160 ____ DM 90/120 |
____ DM 365/430 ____ DM 250/290 ____ DM 190/250 ____ DM 160/190 ____ DM 110/160 |
If rooms in the originally desired category are not available, I agree to the reservation in a hotel of category: ____ |
I will arrive by car: _________ yes _________ no
2. Railway Return Ticket:
Low price return ticket (within Germany) including supplements
for Intercity (IC) or Intercity Express (ICE) trains can only
be booked together with hotel reservation
3. Airport Transfer:
___ TLS Minibus return ticket: Frankfurt -
hotel in Heidelberg - Frankfurt 90DM
Arrival: _____________ at ___________ h, flight no: _________ from: ______________________
Departure: ___________ at ___________ h, flight no: _________ to: ________________________
4. Heidelberg Card:
___ Card(s) for 1-2 days at 19.80DM =
_______ DM; ______
Card(s) for 3-4 days at 34.00DM = ______
First day of validity: ______________
5. Local Traffic and Cable Car Ticket:
___ Ticket(s) for _______
days at 6.00DM/person/day = ______
DM; First day of validity: ______________
Debit-entry authorization to secure reservation oder: I herewith authorize the Convention and Visitors Bureau Heidelberg to debit my
account.nr: _________________ at bank _____________________________
bank no ______________________
___ Master/Eurocard, ___ VISA, ___ AMEX, ___ Diners, Card no:
_____________________________________
valid until: _________________, name of card holder
________________________________________________
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I understand that a fee will be charged for the cancellation or change in the original booking. The fee will be 25DM until one week before the arrival date. Afterwards it will be 25DM plus the amount charged by the hotel. I further understand that the confirmation form as well as the travel documents and the statement of account of the booking order will be sent to me without delay.
City ____________________________
Date ______________________
Signature_____________________________