HOTEL RESERVATION FORM
Academy of Aphasia - 37th Annual Meeting
Please mail before August 20, 1999 to:
VENEZIA CONGRESSI s.n.c.
Dorsoduro 1056 30123 Venezia
Tel. +39/041.5228.400 - fax +39/041.5238.995 E-mail: vencon@tin.it
FAMILY NAME....................................................................................................................................................
FIRST NAME........................................................................................................................................................
COMPANY............................................................................................................................................................
ADDRESS..............................................................................................................................................................
ZIP CODE........................................TOWN...........................................................................................................
COUNTRY.............................................................................................................................................................
TEL............./.............................................FAX........../......................................E-MAIL........................................
| Type of Room | Type of Hotel | ||
| Single Room | **** | ||
| Double room | *** | ||
| ** |
Date of arrival..................................................................Date of departure.............................................................
PAYMENT
A first night hotel deposit of Lit.......................................... is being paid as follows (please check one):| By enclosed cheque nr _________ made out in the name of Venezia Congressi | |||||||||
| By postal money order (copy enclosed) made out in the name of Venezia Congressi | |||||||||
| I give my credit card data, to be used only in the case of no show | |||||||||
|
| Credit Card issued to (name on card) | |
| Credit Card number | |
| Expiration Date | |
| Signature | |
| Today's Date |
| DOUBLE | SINGLE | |
| **** | 520.000 | 400.000 |
| *** | 300/350.000 | 220/260.000 |
| ** | 240/280.000 | 150/180.000 |
Possibility of cheap arrangement for students (on request within July) in double room, breakfast
approx. L. 40.000 p.p. without bath, L. 60.000 with bath.
Please note
* Daily rates include continental breakfast and taxes (per room with bathroom).
* No hotel reservation will be accepted without a deposit corresponding to the maximum rate of the selected
accommodation or by the credit card data as guarantee.
Such deposit will be directly included by the hotel in the final invoice.
* Double room for single occupancy will be assigned when single rooms are no longer available.