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ELECTRICITY CONNECTION REQUEST FORM

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ELECTRICITY CONNECTION REQUEST FORM Powered By Docstoc
					                               ELECTRICITY CONNECTION REQUEST FORM
                                        Please complete this form and return to:
                                        Serenas Tourism – Att: Mr. Sercan Ozalp
                           Turan Gunes Bul. 5. Cad. No: 13 Yildiz Cankaya 06550 Ankara Turkiye
                 Phone: +90 312 440 50 11 – Fax: +90 312 441 45 63 – E-mail: sercan.ozalp@serenas.com.tr
COMPANY DETAILS
Company
VAT number
Contact Person
Address
City                                                Postal Code
Country                               Tel:                                 Fax:
E-mail

ELECTRICITY CONNECTION                             QTY                     Cost                      Total Cost
Electricity connection need                              KW        14,00 EUR, VAT inc./ per KW                    EUR
Plug adapter to 220 volts                                                   5,00 EUR, VAT inc.                    EUR

                                             TOTAL AMOUNT                                        EUR, VAT included
          We kindly ask you to notify us about your power needs for electricity connection with your stand
           designs. Please send us ‘plan’ and ‘perspective’ drawings of your stand with your request for electricity
           connection.
          The electricity power supply in Turkiye has 220 volts.


Payment via Credit Card
       Visa      Master Card       Amex        Diners          Other
Card Number :
CVV / Security Code (last 3 numbers on the back of the card)
Expiry Date (month / year)     /     Card Holder
I hereby authorize Serenas Tourism Congress Organization and Hotel Management Co. (Serenas Turizm Kongre Organizasyon
Otelcilik AŞ) to have my credit card charge the fee, which has the details above.


DATE: June 11, 2010                     SIGNATURE______________________________________




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