HOTEL ACCOMODATION FORM

5 TH ANNUAL ISNVD
Scientific Meeting
March 27 – 29 , 2015
HOTEL ACCOMODATION FORM
PARTICIPANT
________________________________________________________________________________
Family Name
First Name
Please fill in ( complete in block capitals) and return to: MP s.r.l. Congressi e Comunicazione Via Coroglio, 57/D – 80124 Napoli
Ph. +39 081 5753432 - +39 081 2466459 fax +39 081 5750145 e-mail: [email protected] – web site : www.mpcongress.it
________________________________________________________________________________
Address
________________________________________________________________________________
Post Code
City
Country
________________________________________________________________________________
Mobile
Ph./Fax.
________________________________________________________________________________
e-mail
________________________________________________________________________________
Fiscal Code o VAT Num.
Date of birth
Place of birth
ACCOMPANYING PERSON
________________________________________________________________________________
Family Name
First Name
HOTEL RESERVATION (to be filled in and sent within December 10th 2014)
Selected Hotel
Single Room
Double Room
Hotel *****L deluxe
€ 230,00
€ 260,00
€ 220,00
€ 250,00
€ 149,00
€ 169,00
€ 155,00
€ 180,00
( HOTEL VESUVIO)
Hotel ****S deluxe
( HOTEL EXCELSIOR)
Hotel **** superior vista mare
( HOTEL ROYAL)
Hotel ****
(HOTEL S. LUCIA )
________ _
ARRIVAL DATE
_____________
DEPARTURE DATE
________
FEE AGENCY € 20,00 Total amount
€………………………………….
N° of nights
* (Price is per room per night including breakfast. To be added tourist tax € 2,50 per person per night payable locally)
RULES 'OF RESERVATION:
This booking form must be sent to MP Congressi duly completed and accompanied by a copy of the bank transfer
or credit card for the total amount your stay .
Reservation and payment must be made:
Hotel Royal by 25 October
St. Lucia Hotels by 6 November
Hotel Excelsior / Hotel Vesuvio by December 1
Will not be taken into account the reservations did not have the details of the payment.
Booking is subject to availability and will be confirmed by the MP srl Conferences and Communication, each
participant will receive confirmation of your reservation with the hotel name and address.
PAYMENTS
ALL PAYMENTS MUST BE MADE IN EURO AND ADDRESSED TO
MP S.R.L. AND MARKED WITH THE CODE
“5th Annual ISNVD + name and surname of the registered person”
Credit Card / Please charge the sum of Euro _______________ + transit commission bank € 9,00
from
Visa
Master Card
Carta Si
Card Number n._ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Expiration Date
/
/
Number of security __ __ __ * Corresponds to the last 3 digits of the identification number on the back of the card
Cardholder_______________________________________________________________________
Signature___________________________ Date ________________________________________
Bank Transfer / (net of bank charges) Euro ___________________________________
Account holder: “MP srl Congressi e Comunicazione” Bank: Banca della Campania Ag. 1 – Napoli
Account n. 211837 Abi code: 05392 Cab code : 03401 Cin T
IBAN code : IT28T0539203401000000211837 – SWIFT code: BPMOITC1
Certification of payment made by bank transfer m ust be mailed or fax ed w ith the registration form .
INVOICING (please fill
only in case invoice should be named and addressed to another subject)
Family Name ___________________________ First Name _____________________________
Address________________________________________________________________________
City ____________________________ Country ________________________Post Code_______
Fiscal Code o VAT Num. ___________________________________________________________
Date___________________________ Signature ________________________________________
In accordance with Legislative Decree 196/03 I authorize the use of data provided for the purpose of receiving information and notices.