Print this page and send it by fax to the hotel: +351 222 006 510

EuroLogo'2003 - Hotel Registration
Residencial Brasília
 

Personal Information
Name: ______________________________________________
 
Address: ______________________________________________
______________________________________________
______________________________________________
 
Country: ______________________________________________
 
Email: ______________________________________________
 
Telephone
or Fax:

______________________________________________
 

Accommodation
Arrival date: ____/__/__ Departure date: ____/__/__
Rooms:  Single Double  
Observations:
Single room (1 bed): 32,50 €
Single room (suite): 37,50 €
Double room (1 beds): 37,50 €
Double room (2 beds): 40 €
Double room (suite): 42,50 €
Double room: 50 €

Payment
Monney Check
Credit Card VISA Credit Card MASTERCARD
Credit Card AMERICAN EXPRESS Multibanco

Dead line for registration: