ACCOMMODATION FORM FOR LEARNING'00

                To be faxed to:  Learning'00 Secretariat, Fax: +341 624 9430


Full Name:    ______________________________________________________
Affiliation:     ______________________________________________________
Full Address:______________________________________________________
                    ______________________________________________________
E-mail:          __________________ Ph.:  _____________ Fax:  _____________


HOTELS

   Please, tick your choice

   __ Student Residence
   __ Hotel Sol Inn Leganés
   __ Hotel Sur
   __ Hotel Nacional

   Type of room: __ Single      __ Double

   Arrival date: _______________ Departure date: _________________

PAYMENT BY CREDIT CARD

      __Master Card     __VISA          __AMEX

    Card Number: _______________________  Exp. date:____________
    Cardholder's name: ________________________________________
 

    Cardholder's signature: ____________________________________
                                          (mandatory)
    Do you need a receipt? __YES __NO