HEP2005 International Europhysics Conference on High Energy Physics
                      July 21st to July 27th, 2005
                           Lisbon, Portugal 
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                  LIP  reservation form  -  Hotel D. Manuel I
                            deadline: 23-May-2005
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  FIRST  NAME: _____________________________________________________

  INSTITUTION: _____________________________________________________

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     (TYPE AN  "X"   IN THE SPACES CORRESPONDING TO YOUR CHOICES)


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                        ___ Double (63 Euro/day)

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    PRINT and send by fax to       Hotel D. Manuel I
                                   Av. Duque de Avila, 189
                                   1050-082 Lisboa, Portugal

         Fax: +351-21-357-6985     Tel: +351-21-359-3000
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