Booking form - Réservation Hotels

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Booking form - Réservation Hotels Powered By Docstoc
					                      « Novel targeting drugs and radiotherapy :
                            from the bench to the clinic »
                                 June 16 - 17 th 2005
      Deadline for reservation : May 1st 2005 booking will then be accepted
                          according to hotel vacancies :
            HOTEL 2 **                               HOTEL 3 ***                       HOTEL 4 ****
De / From 61€ à / to 75 €                    De / From 100€ à / to 160 €       De / From 150€ à / to 260 €
Single      Double      Twin/                Single     Double      Twin/      Single     Double      Twin/
                        2lits                                       2lits                             2lits

Will you need a car                    Yes
parking
                                       no
Point your choice

Family Name :
First Name :




E.mail :                                                Guarantee of your reservation by your credit card




Tél :                                                   CREDIT CARD NUMBER :                          DINERS


Fax* :                                                                                                VISA
Arrival Date :                                                                                        AMEX
Departure Date :                                                                                      Master


Number of nights :                                      EXPIRATION DATE :                             Eurocard



For any special request please contact us directly
e.mail : isabelle.reservhotels@wanadoo.fr
                                                     RESERV’HOTEL MP
                                                     Tel : +33-(0) 892 700 297
                                                     FAX : +33-(0) 892 700 298 or 33 (0) 5 34 31 71 47
* Do not forget to mention your fax number
Your Hotel confirmation will be sent by fax or by e.mail with the hotel
address.

				
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