Hotel Reservation Form

Geodynamics 2016 In 5 out 10 June 2016

Deadline: 8th of April 2016 NH Trieste CORSO CAVOUR n.7, 34132 Italy Individual reservation department: Telephone: 848 390 398 / +34913984400 e-mail: [email protected]

First Name: Family Name: Address: City and Postal Code: Phone: Accompanying Person (s) (if any - please list):  BUILDING A Standard Room Sgl use: € 105,00 Number of rooms:______  Standard Room dbl use: € 115,00 Number of rooms:______  Supplement 3 rd person € 30,00 Company: Country: Fax: Email:

Date check in / check out

INFORMATION: rooms The above mentioned daily room rates include buffet breakfast and actual 10 % VAT

Kindly note:

Reservations deadline 8 th April 2016 AFTER THIS DATE RESERVATION REQUESTS WILL BE ACCEPTED UPON AVAILABILITY. All requests must be accompanied by a credit card number and expiration date to guarantee your room reservation.

Credit Card Information:

 American Express  Diners Club   Visa Carta Si  Master Card Credit Card number Expiration date Cardholder signature:

** Check-in time is from 3.00 pm - Check-out time by 10.00 am Hotel Cancellation Policy

Hotelstamp for reconfirmation Up to 72h before the arrival date: no penalty will be charged for cancellations After the 72h until arrival: 100% of the total reserved stay will be charged to the credit card given NO SHOWS WILL BE CHARGED 100%. EARLY DEPARTURES WILL BE CHARGED 100%

Please send this form within : Deadline 8 th April 2016 E-mail: [email protected]

Guest's signature for acceptance and approval:

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