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heb PYFF 5 - INRA Montpellier

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					                               5th Conference on Physiology of Yeast                                INDIVIDUAL ACCOMMODATION FORM
                                                                                                TO BE RETURN WITH THE PAYMENT ENCLOSED TO :
                               and Filamentous Fungi                                                                  ENJOY - LE CORUM - Service Hebergement
                               June 4 - 7, 2013, Montpellier, FRANCE                                                       BP 2200 - Esplanade Charles de Gaulle
                                                                                                                                     34027 MONTPELLIER Cedex 1
                                                         st
                               DEAD LINE : May 1 , 2013                                                         Tél : 33 (0)4 67 61 67 61 / Fax : 33 (0)4 67 61 66 84
                                                                                                                             hebergement@enjoy-montpellier.com


  Family NAME                                                                         First Name

  INSTITUTION

  ADDRESS



  ZIP CODE                                                             CITY

  COUNTRY

  PHONE                                                                            FAX

  E MAIL

  I will be accompanied by       : Family Name : ....................………........... First Name :...................
  I wish to stay in the same hotel as : Family Name : ...…………………............. First Name :...................

  HOTEL                                  I wish to reserve a room in a hotel                    :
  ROOM                                   …...room(s) for…... person(s)                               Single         Double           with 2 beds

  ARRIVAL / DEPARTURE                    Arrival on June….………                                        Departure on June,……….


                       LODGING COST TABLE per night, breakfast included BB – (subject to variations)
                                                              Choice N°       Single rate Double rate                     Fixed deposit per room
 CATEGORY                        HOTELS
                                                                 …               BB          BB                       (includes administrative fee : 10 €)
 ***               KYRIAD ANTIGONE                                                  129 €       139 €                                  130 €
 ***               NEW HOTEL DU MIDI                                                 115 €               135 €                         130 €
 ***               IBIS COMEDIE                                               114 à 118 €       124 à 128 €                            120 €
 ***               IBIS CENTRE                                                114 à 118 €       124 à 128 €                            120 €
 ***               ULYSSE                                                            117 €               134 €                         120 €
 ***               ROYAL HOTEL                                                       100 €               120 €                         120 €
 ***RH             PARK & SUITES MILLENAIRE                                           97 €               105 €                         120 €

  City tax not included (per person, per day)     I want to receive an economic hotel list, I will reserve by myself : □
Prices listed include daily room rate, daily breakfast, VAT and service charges, and are valid until 31 December 2013 subject to variations
dependent on the hotel decision. The deposit includes administrative fee of 10€ for ENJOY-LE CORUM.
Only requests accompanied by payment will be processed. Reservation requests received after May 1st , 2013 will only be processed
to the extent of our availabilities.
CANCELLATION : Only cancellation made in writing to ENJOY-LE CORUM (e-mail or fax) at least 10 working days prior to the event will be refunded
after deduction of 10 € for administrative fees. No modification or cancellation will be accepted by phone.



                BY CHEQUE TO ENJOY-LE CORUM / HEBERGEMENT PYFF 5 - BP.2200, 34027 MONTPELLIER Cedex 1 – France


                BY SWIFT TRANSFER to the account of ENJOY- LE CORUM / HEBERGEMENT PYFF 5 :
                ACCOUNT NUMBER, IBAN : FR76 1027 8089 8200 0204 5700 192CMCIFR2A
                BANK CCM ETOILE, Place Ernest Granier - 34000 MONTPELLIER - France

                Please inform your bank that the transfer fees will be charged to the sender

                BY CREDIT CARD :                                                (NO AMERICAN EXPRESS )


                I undersigned .................................... hereby authorize the CORUM to charge the sum of ............... € to my :
                         VISACARD       □                     MASTERCARD       □                    EUROCARD        □
                  N°                                                                           EXPIRATION


                        DATE:                   SIGNATURE :

				
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posted:6/5/2013
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