Young Researchers Symposium July 25 - July 26, 2003 * Instituto Superior Tecnico, Lisbon, Portugal =============================================================================== Please fill in and Fax, Mail or Email this form to: AIMS International Portugal Phone: +351 213245052/53/54 Rua Garrett, 61 - 3 Fax: +351 213245051 1200-203 Lisboa Email: icmp2003@aims.pt =============================================================================== HOTEL ACCOMODATION FORM: Please fill in clearly in capital letters Family First Middle name: _______________ name: _______________ initial: __ Title: ____________ Address: ______________________________________________________________________ Zip Code: ____________ City: __________________ Country: _____________________ Daytime phone: __________ Fax: __________ Email: ____________________________ Arrival date: ___________ Departure date: _____________ Number of nights: ___ Accompanying person: Family name: _______________ First name: _______________ Mr[ ] Mrs[ ] Ms[ ] *PLEASE BOOK: Single room [ ] Double room [ ] 1st choice hotel: _____________________ SGL[ ] DBL[ ] One-night cost: _____EUR 2nd choice hotel: _____________________ SGL[ ] DBL[ ] One-night cost: _____EUR 3rd choice hotel: _____________________ SGL[ ] DBL[ ] One-night cost: _____EUR PAYMENT By credit card: Visa [ ] MasterCard [ ] American Express [ ] *In case of payment by Credit Card you will receive an extra form by fax where you have to fill in your Credit Card details and signature. By bank transfer [ ] Bank name: Nova Rede Tagus Park Account number: 00 33 000000 200 41 596905 Swift code: BCOMPTPLLMR *Please note that the banking fees have to be settled by the remitter and you MUST mention your name, registration number and the purpose of your payment, so that the money can be assigned to your account. REMAINING OF PAYMENT DIRECTLY TO THE HOTEL HOTEL BOOKING CONDITIONS 1. Rooms will be alocated on a "first come, first served" basis according to availabilities. 2. Reservations can only be made with the Hotel Booking Form or via the Internet. 3. Accomodation will be only guaranteed when the payment of the one-night deposit has been received by the AIMS Portugal. 4. After the 24th June 2003 only payment by Credit Card will be accepted. HOTEL CANCELATION POLICY Cancellation up to two months prior to the arrival: no charge. Cancellation from two months onwards: one-night deposit. Name change or other alteration: 20 EURO I have read and accepted the booking / cancelation / alteration as printed on this form Date: ____________ Signature: ________________________________________________