7TH EURETINA CONGRESS
EXHIBITOR HOTEL BOOKING FORM REGISTRATION NO.
FOR OFFICE USE ONLY
LAST NAME: FIRST NAME:
Single Double Single Double
Monte Carlo Bay 5* E251 E265 Hotel Ambassador 3* E165 E165
Fairmont 5* E244 E244 Bahia Vista Hotel 3* E110 E140
Colombus Hotel 4* E205 E225 Hotel Alexandra 3* E110 E132
Tulip Inn 3* E175 E175 Hotel de France 2* E115 E115
Rates are per room per night and include taxes and breakfast. It is advisable to book your accommodation early.
Please note that 50% of the total accommodation cost is due with this booking form and 50% by 1 March 2007.
Arrival Date:_______________________ Departure Date:_______________________ No. of Rooms:___________________
Type of room: Single ❐ Double ❐ Twin ❐ Other ❐ Please specify ________________
HOTEL REQUIRED Please enter 3 options below, as your first choice may not be available.
3 Digit Security Code
PAYMENT METHOD (Visa & Mastercard only,
printed on the reverse of card)
Visa ❐ MasterCard ❐ American Express ❐
Card No. Exp
Cardholder Name (PLEASE PRINT):
Cardholder Signature: Date:
PAYMENT TERMS & BANK DETAILS CANCELLATION POLICY
Name of Account: Agenda Cancellations prior to 1 December 2006 - 50% cancellation fee
Bank: AIB International Banking Cancellations prior to 1 March 2007 - 80% cancellation fee
Ashford House, Tara Street, Dublin 2, Ireland Cancellations after 1 March 2007 - 100% cancellation fee
IBAN: IE63 AIBK 930067 17223684
Swift Code: AIBKIE2D
50% PAYMENT MUST ACCOMPANY THIS RESERVATION FORM
Please return completed form to AGENDA COMMUNICATIONS, Temple House, Temple Road, Blackrock, Co. Dublin, Ireland
Tel: +353 1 288 3630 Fax: 353 1 288 3636 Email: firstname.lastname@example.org
17 - 20 May 2007