Print this page and send it by fax to the hotel: +351 225 095 165

EuroLogo'2003 - Hotel Registration
Hotel Residencial Palanca
 

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

______________________________________________
 

Accommodation
Arrival date: ____/__/__ Departure date: ____/__/__
Rooms:  Single: 45€ Double: 57,50€ Triple: 71,25€
Observations:

 

 


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

Dead line for registration: