ECPPM’2000 Conference - September 25-27, 2000 Hotel Costa da Caparica **** Avª General Humberto Delgado, 47 Costa da Caparica - 2825 Monte da Caparica, Portugal Tel.: +351-21-291 89 00 - Fax: +351-21-290 64 04

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Fax Transmittal

 To:   Reservation department            Fax:   +351 212 90 64 04

From:

(Name)______________________________________________________________________

(Institution)__________________________________________________________________

(Address1)___________________________________________________________________

(Address2)___________________________________________________________________

(City)____________________________(Country)___________________________________

(Tel.:)_________________________(Fax)____________________(e-mail)_______________

 

I would like to book the following number of rooms, arriving__________at _____hours and leaving__________at___hours, in a total of _______ nigths.

 

 

Name of person sharing with: ___________________________________________________

                  

I understand that to secure this reservation my credit card number or a deposit of the first night's accommodation is required. Credit card will be charged only after arrival. This reservation may be cancelled up to 48 hours before my foreseen arrival, without any penalty. All reservations are subject to confirmation.

 

Reservation Date:__________________Signature ________________________________

 

Card Type:  __________Credit Card Number: _____________________ Exp.Date: _____

Cardholder’s Name: _____________________________Signature:___________________

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REPLY (Only to be used by the Hotel’s Reservation Desk to confirm this reservation)

We confirm this reservation

 

Date:________________                   Signature ___________________________________