Surname ___________________ First Name _____________

Complete Address __________________________ City ___________________

Postal Code ___________ County _______________ Country ________________

Phone _______________ Fax _______________

Accompanying Person __________________________ Total persons _____

Hotels	Class/Obs	Single	Twin (2 people)
Bosque Sol	***	3,850 SPA	5,500 SPA
Isla Mallorca	***	5,500 SPA	7,800 SPA
Araxa	***	6,500 SPA	8,000 SPA
Mirador	***	7,500 SPA	9,800 SPA
Saratoga	***	7,850 SPA	11,800 SPA
Melia Bellver	**** (Room only-Without breakfast)	8,000 SPA	12,100 SPA

All prices are per person and per room in Spanish pesetas, including breakfast and VAT.

All hotels listed above are within walking distance of the Symposium site.

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Please make reservation at the __________________ Hotel

Type of room __________

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Arrival date _________ Departure date _________ Total nights _____

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Rate per day __________ x _____ total nights x _____ people.

Total pesetas (SPA)___________

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Form of Payment

A) By Credit card: Visa __ American Express __ Diners __

(Please tick credit card)

Credit card n║ _____________________________ Expiry date ______________

Name (as it appears on card) _________ Authorized Signature ____________

B) By Telegraphic bank transfer to the following account (Please ensure you indicate your name on all transfers)

• Banco Bilbao Vizcaya - Plaza del Olivar, s/n - 07002 PALMA DE MALLORCA - Spain
• Account number : 0182-2368-36-0000323805
• Account name : C.I.C., S.A.

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Please send this form together with payment to :

• C.I.C., S.A.
• C./ San Miguel, 30, 4║D - 07002 Palma de Mallorca - Spain
• Tel.: 34 (71) 72 49 34.....Fax.: 34 (71) 71 35 45
• E-Mail: cic@jet.es

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