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					Hotel Reservation FAX
ICFA-HB2004 workshop October 18-22, 2004

send directly to: Tourist Information Bensheim Hauptstr. 39 D-64625 Bensheim FAX: +49 62515826331 phone: +49 62515826314

I reserve a hotel room for the ICFA-conference for: Name: ______________________________________ Organization: ________________________________ Address:_____________________________ City: _____________________________

Country:_____________________________ Email: _____________ Fax: _____________ Phone: _____________

Hotel preference (give numbers 1, 2, 3): Ramada-treff ___ Bacchus ___ Präsenzhof ___ Arrival date: _____________

Departure date: _____________ Single room: ____ Double room: ____ (name of 2nd person:.............................)

Other requirements: ___________________________________________________ Credit card type ___________ Credit Card Number ________________________________ Expires ___________ Cancellations directly with hotel! Signature _________________________________________


				
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posted:12/29/2009
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