A C C O M M O D A T I O N   R E Q U E S T 



Please print clearly and send by postal mail.


           I wish to reserve ______ single room(s) and/or ______ double rooms in the 
           

hotel: ____________________________________________________________


Arrival Date: __/__/__  Departure Date: __/__/__ Number of nights: ___________


Participant:       (   )  Mr              (   ) Mrs


Last Name: _______________________ First Name:  _______________________ 

Affiliation: ________________________________________________________


Address: __________________________________________________________


Country: ________________ Postal Code: _________ City:__________________


Telephone: _______________________ Telefax: __________________________


Date: __/__/__  Signature: ____________________________________________