ISSS 27/28 March 2000 

Booking form for accommodation in PRAGUE only
pre/post conference

Please complete this form and return it by fax to:

Čedok

Irena Hávová
Congress & Incentive Department
Fax No.: 00420 2   2321756

Surname: ……………………………        First name: ………………………………………

E-mail: …………………………………..

Phone: …………………………………… Fax: ……………………………………

  Single room                               Double room

Arrival date: ………………….       Departure date: …………………..

Estimated budget: CZK ……………

CONFIRMED HOTEL in PRAGUE: (will be filled in by travel agent ČEDOK) 

Hotel name: …………………………………………….

Address: ………………………………………………..

Fax: ………………………………….       Phone: …………………………………..

PAYMENT by Credit card has to be made in full in advance, by : ………………………..  

	Please charge                                CZK to my credit card (mark the appropriate)
	 Visa /  Euro Mastercard /  American Express /  Diners Club
Credit card number:	Expiry date:	
		
Credit card holder’s name:		

Date:                                             	Signature: