LECC 2003

LECC 2003 Amsterdam Hotel Registration Form, 29 September - 3 October 2003

Attention!
This is not a secure form. If you wish, you may fill out this form,
print it and fax it to Carlson Wagonlit Travel (fax: +31 20 305 5334)

Please book a hotel NOW. Amsterdam is almost continously fully booked!

Family Name:	Title:	Mr	Ms	Mrs
First Name:
Address 1:
Address 2:
City:
Postal code:
Country:
Telephone:
Fax:
Email:

Please reserve on my behalf for night(s)

in Hotel	Single room	Twin room
Casa 400 *******	€ 77	€ 100
Lancaster Hotel *******	€ 105	€ 115
Ibis Stopera *******	€ 128	€ 151
Schiller ********	€ 168.50	single rooms only!
Caransa ********	€ 168.50	€ 190.22

Date of arrival: [dd-mm-yyyy]

Rates are per room, per night and including breakfast and taxes.

PAYMENT

Full payment plus € 13 administration and bank charges are required and have to be remitted in advance. Upon receipt of this amount, the hotel reservation will be confirmed and a hotel voucher will be faxed.

I will pay the total amount of € by remitting the amount to the ABN-AMRO Bank, Vijzelstraat, Amsterdam SWIFT-code: ABN.ANL 2A, Account Number: 41.11.55.210 in favour of "Carlson Wagonlit Travel". *
MasterCard/EuroCard	Exact name on Card
Visa	Card Number [xxxx-xxxx-xxxx-xxxx]
American Express	Expiry Date [xx/xx]
MasterCard/EuroCard holders: please note that you need to fill out your CVC code as well. This is a 3-figure code on the back of your credit card following the credit card number. CVC-code

*Please state "LECC 2003" and the full name of the participant on the bank transfer!
Payments must be made in Euro (€) and without any additional charges to the beneficiary.

CANCELLATIONS AND REFUNDS

The prepaid amount minus € 23 for administrative charges will be refunded, provided a written request is received by Carlson Wagonlit Travel before xx XXXX 2003.
By sending in this registration form, I acknowledge that I commit myself to the immediate payment of the hotel fee. I have taken notice of the cancellation terms on this form.

Return Address:
DATE:

Carlson Wagonlit Travel

Paulus Potterstraat 8

1071 CZ Amsterdam
SIGNATURE:

The Netherlands

telephone: +31 20 305 5335

fax: +31 20 305 5334

email: cad@keytours.nl

Return Address:	DATE:
Carlson Wagonlit Travel
Paulus Potterstraat 8
1071 CZ Amsterdam	SIGNATURE:
The Netherlands
telephone: +31 20 305 5335
fax: +31 20 305 5334
email: cad@keytours.nl