CALOR99 - VIII International Conference on Calorimetry in High Energy Physics June 13-19, 1999 Lisbon, Portugal ----------------------------------------------------------------------------- RESERVATION FORM - HOTEL AMAZONIA ----------------------------------------------------------------------------- FAMILY NAME: _____________________________________________________ FIRST NAME: _____________________________________________________ INSTITUTION: ___________________________________________________ ADDRESS: ___________________________________________________ ___________________________________________________ PHONE: ___________________________________________________ FAX: ___________________________________________________ (TYPE AN "X" IN THE SPACES CORRESPONDING TO YOUR CHOICES) Please book me a ___ Single Room ___ Double Room (11100 PTE/day) (12600 PTE/day) Date of arrival: ______________ Date of departure: ______________ Please note that your reservation can be guaranteed only if a credit card number is indicated. Use my CREDIT CARD to guarantee my reservation. The guarantee deposit corresponds to 2 nights. Reservation can be cancelled without any penalty until April 12th. 1 night will be charged for cancellations before May 12th, and 2 nights if the cancellation is after May 12th. The full period will be charged in case of no-show. ___Visa ___Eurocard ___Mastercard ___American Express Credit card number: _____________________________________ Credit card name: _____________________________________ Expiry date (e.g. 11/99): ____/____ Signature: _____________________________________________ PRINT and send by FAX to HOTEL AMAZONIA Travessa da Fabrica dos Pentes, 12 a 20 1250 Lisboa, Portugal FAX: +351-1-3879090 PHONE: +351-1-3877006