Please print this form, fill it in and send it before September 1st 2015: VIAJES EL CORTE INGLÉS, S.A. Avda. Cantabria, 51 • 28042 Madrid (Spain) • Tel.: +34 91 454 60 14 • Fax.: +34 91 559 47 89 • e-mail: srps6@viajeseci.es ACCOMMODATION FORM: Data required are marked with asterisk (*) Prof. Dr. Mr Mrs First name:* ................................................................................................................................................................................................................................... Family name:* ................................................................................................................................................................................................................................ Sex:* .......................................................................... Nationality/Citizenship:* ............................................................................................................................. Address Department:* ................................................................................................................................................................................................................... Institute/University/Company:* ...................................................................................................................................................................................................... Street, No., P.O.Box:* ...................................................................................................................................................................................................................... Postal (ZiP) code:* ............................................................. City:* .................................................................. Country:* .................................................................. Phone Nº.:* ......................................................................................................................... Fax Nº.: ............................................................................................. (country code/area code/number) (country code/area code/number) E-mail:* ........................................................................................................................................................................................................................................... First & family name of the accompanying person(s):* ..................................................................................................................................................................... .......................................................................................................................................................................................................................................... HOTEL: DOUBLE FOR SINGLE USE ROOM DOUBLE ROOM 80,00 € 80,00 € 88,00 € 107,80 € 115,50 € 94,00 € 143,00 € 90,00 € 90,00 € 99,00 € 118,80 € 126,50 € 104,00 € 154,00 € HOTEL NH BALBOA *** HOTEL NH ZURBANO *** HOTEL NH BRETÓN *** HOTEL MELIÁ GALGOS **** HOTEL NH PRÍNCIPE DE VERGARA **** HOTEL VP EL MADROÑO **** HOTEL ABBA MADRID **** Breakfast and taxes included in the room rates Hotel: ...................................................................................................... Room type: ................................................................................................................... Number of rooms: ................................................................................... Day in: ........ /........ /........ (dd/mm/yy) Number of nights: ................................................................................... Day out: ........ /........ /........ (dd/mm/yy) Note: 100% penalty for no show Total Amount: ................................ € METHODS OF PAYMENT For International transfers: Bank transfer to “Viajes El Corte Inglés, S.A.”: Ref.: SRPS6 2015. BBVA Bank: IBAN: ES97 0182 3999 3702 0066 4662 • BIC NUMBER: BBVAESMMXXX • Please, forward by fax or email a copy of your bank transfer receipt to enable us to locate your payment promptly. The payment must be free of bank charges. • Application received without payment will not be accepted. For Spanish transfers: Bank transfer to “Viajes El Corte Inglés, S.A.”: Ref.: SRPS6 2015. Banco Santander Central Hispano (BSCH): 0049 1500 03 2810355229 • Por favor, ruego nos envíen copia de la transferencia vía fax o email para localizar el pago en nuestro sistema lo antes posible. IMPORTANT NOTE: • Your registration will not be accepted without the corresponding payment. ............................................................................................................................... CANCELLATION POLICY: Hotel bookings until 1 June. • 1 month before the meeting we will charge the first night of the booking. • 100% of cancellation fees will be charge 15 days before the entrance. The personal details included in this document, are of a confidential nature. In accordance with the Constitutional Law 15/1999, of 13 December, the holder of this data will be able to exercise his or her rigth of access, rectification and cancellation on written application to: Viajes El Corte Inglés, S. A; Servicios Centrales - Dpto. de Organización y Métodos. Avda. de Cantabria, 51; 28042 Madrid. TECHNICAL SECRETARIAT: Viajes El Corte Inglés Avda. Cantabria, 51 • 28042 Madrid Tlf.: +34 91 454 60 14 Fax: +34 91 559 47 89 E-mail: srps6@viajeseci.es