C
11th. EUROPEAN CARBOHYDRATE SYMPOSIUM - EUROCARB XI
September
2 7, 2001, Faculdade de Ciκncias da Universidade de Lisboa, Portugal
HOTEL ACCOMMODATION FORM
Please write in capital letters or
use a typewriter:
Family name:
First name:
Title:
M/F
.
.
Institute or
Company:
..
..
Address:
.
.
..
Postal
Code/City:
....Country:
..
...
.Phone
..
...
...
Email:
Fax:
.
..
....
I would like to share the room with:
.
.
Please
reserve on my behalf for
....nights single room
double room
.
Date of arrival:
. Date
of departure
|
HOTEL* |
SINGLE ROOM EURO (PTE) |
DOUBLE ROOM EURO (PTE) |
|
Hotel Tivoli (*****) |
145 (29000) |
160 (32000) |
|
Hotel Sheraton (*****) |
145 (29000) |
160 (32000) |
|
Hotel Radisson S.A.S (****) |
100 (20000) |
110 (22000) |
|
Hotel Melia Confort Lisboa (****) |
135 (27000) |
115 (23000) |
|
Hotel Quality (****) |
90 (18000) |
95 (19000) |
|
Hotel D. Carlos (***) |
68 (13600) |
78 (15600) |
|
Hotel Eduardo VII (***) |
62 (12400) |
73 (14600) |
|
Hotel Berna (***) |
53 (10600) |
63 (12600) |
|
Hotel Ibis Malhoa (***) |
53 (10600) |
57 (11400) |
|
Residencial Imperador (1st. category) |
41 (8200) |
47 (9400) |
|
Student residence Pio XII** |
28 (5600) |
45 (9000) |
*Prices are per room and per night including breakfast.
**Only for students. A letter of endorsement of the supervisor is required.
PAYMENT
· By enclosed cheque (EURO) payable to MUNDIVISA
· By Eurocheque
· By bank transfer to MUNDIVISA
SINIBANCO Av. Duque dΑvila
Account Nr. 007600001153326210136
·
AMERICAN EXPRESS
VISA
CARD
.. MASTER CARD
..
Card number
___________________________ Expiration
date______________________
Owner name____________________________ Authorised Signature__________________
DATE:
SIGNATURE:
Please return this form, together with
the payment, before May 15, 2001 to:
Mrs. Anabela
Palma
MUNDIVISA, Campo
Grande, nr. 4, 1Ί Esq.
1700-092 Lisboa,
Portugal
Email : viagens-turismo@mundivisa.pt; Fax : + 351 21 7931742 ; Phone : +351 21 7937129/7934267