Prenotazione di soggiorno

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Prenotazione di soggiorno ...


    Culturale PRIME2006

    Ph.D. Research in

    MicroElectronics ndth15 , 2006 June, 12 Otranto (Lecce), Italy


    Hotel Reservation Form

    Grand Hotel Club Daniela **** (Reservation office)

    Phone +39 049 8033780 fax +39 049 8033785 Please fill in this form

    and send it via fax to: Via Forcellini, 170 / A I 35128 PADOVA


    (working time: Mo.-to Fr. 9 am-1pm & 3pm-7pm)

    Send all the three pages (one signature per page) !!!!

    Title ? Mr. ? Mrs. (please tick the right box) First name

Last name

Complete address

Date of birth

Town and Country of birth






    Only one week reservation will be guaranteed. ththArrival date: June, 10, 2006 Departure day: June, 17 , 2006 ? double as single use room ? 560,00 (deposit 186,00 ?) ? ………………………. ? double room ? 455,00 (deposit 151,00 ?)

If double room has been chosen

? I will share the double room with____________________________________

If you do not choose a roommate, you will be accommodated in same-sex room with another person.

    Conference registration

    ? Student registration ? 400,00 th? Regular Registration (before April, 24? ………………………. , 2006) ? 450,00 th? Regular Registration (after April, 24, 2006) ? 500,00

    Total amount ? ……………………….

Your signature for acceptance_____________________________________

Page 1 of 3


    Culturale PRIME2006

    Ph.D. Research in

    MicroElectronics ndth15 , 2006 June, 12 Otranto (Lecce), Italy


    General conditions:

    The rooms will be available for occupancy from 16.00 h. on the day of arrival and must be vacated by 10.00

    h. on day of departure. The rate is per person in full board arrangement, drinks with the meals included

    (mineral water and “della casa” wine), vat included.

    Services included in the accommodation fee

    Hotel accommodation with Full Board arrangement, drinks with the meals included (mineral water and “della

    casa” wine), club card included. The club card gives you for free these services: N. 1 sunshade and N. 2

    deckchairs for each family or room on the beach, Birba Club entertainment (4-12 years old); day and night

    entertainment, live piano bar; daily use of tennis court and 5-a-side football pitch, tournaments, bowling

    alley, free use of canoe, sail, wind surf; gymnastic, aerobic; use of the 2 swimming pools (one for children).


    Children 0 to 5 year old : free of charge. 3rd bed for children 6 to 9 year old: 50%. 3 rd bed for adults: 15%

    Family plan: 2 adults and two children (till 15 year old) in room joined with the parents’ room, 30% reduction

    only for the children.

    At extra cost

     Individual lessons for sporting activities, Beauty centre, Transfer to and from major railway stations and

    airports, Excursions, by sea and land, Flood-lit tennis and five-a-side football,

    Medical assistance at pre-arranged times, Grilled fish on the beach

     Animals: not admitted

I will pay the following amount, net of bank charges,

    Total amount ? ……………………….

By (please tick the right box)

    ? Bank wire ? Credit card By Bank wire to GE.TI.MED. Spa


    Agenzia di Padova-Camin

    C/C 000030040144 CAB 12100 ABI 03226 CIN L

    IBAN: IT 24L 03226 12100 000030040144


    Please specify your name and “PRIMEConference Fee”

    By Credit card Credit card type: ? Visa ? Mastercard

    Credit card number

    Expiring date

    At name of

    I authorize to proceed with the withdrawal of

    ? ………………………………….

    from my credit card as confirmation deposit for the above mentioned stay and

    conference registration.

    Date Signature

Page 2 of 3


    Culturale PRIME2006

    Ph.D. Research in

    MicroElectronics ndth15 , 2006 June, 12 Otranto (Lecce), Italy


    Cancellation policy In case of your cancellation the Grand Hotel Club Daniela (GE.TI.MED. Spa) will not refund your deposit as


    Reservation form Please send your bank transfer confirmation or the authorization to withdraw the deposit from your credit

    card together to a signed copy of this form to our fax n. +39 04 98033785

    Balance due: the credit balance will be paid at the arrival to the hotel.

    Confirmation of your reservation Once the hotel has received your form, we will send to you the definitive reservation.


    thYou are supposed to send this form by April, 24, 2006; beyond this date the hotel is no longer assuring the

    availability of the rooms.

Wishing you a good stay,

Your signature for acceptance_____________________________________

Date _____________________________

    Page 3 of 3

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