WWMM
                           WW Physics Workshop

                        November 1st - 4th, 2000
                           Sesimbra, Portugal 

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                         HOTEL RESERVATION FORM
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IDENTIFICATION

      Family Name: ___________________________________________________

       First Name: ___________________________________________________

          Address: ___________________________________________________

                   ___________________________________________________

           e-mail: ___________________________________________________

        Telephone: ___________________________________________________

        Facsimile: ___________________________________________________


RESERVATION

        Date of Arrival: _31/10_____    Date of Departure: _4/11______

        Number of
          Persons: _1___ Single Occupancy: _X__ Double Occupancy: ____

          Full board (extra charge 3,800.- PTE (dinner)): NO:_X YES:__

        Prices/night/person (PTE):  

                  Conference days: 12,400.- (single)  9,300.- (double)

              Extra night (after):  9,500.- (single)  6,100.- (double)


RESERVE PAYMENT (FIRST NIGHT)

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

    _X_ CREDIT CARD

        Total amount: _12,400.-_ Currency: _X PTE __ Euro

        ___Visa   ___Eurocard  ___Mastercard  ___American Express 

        Credit card number: _____________________________________

        Credit card name:   _____________________________________

        Expiry date (e.g. 11/00):  ____/____

        Signature:  _____________________________________________


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PRINT and send by FAX or LETTER to      HOTEL DO MAR
                                        c/o Cristina Silva
                                        Rua General Humberto Delgado, 10
                                        P-2970-628 Sesimbra
                                        Portugal

         Tel: +351-21-228-8301          Fax: +351-21-223-3888