PRAGUE QUADRIENNAL 2003
Accommodation offer |  Other services |  Application form
APPLICATION FORM
PRAGUE INTERNATIONAL Travel Agency
Contact persons:supervisor Miss Jarol�mkov� Petra
Mrs. Eva Fi�erov�, Mrs. Pavla Ku�erov�, Mrs. Kv�ta �edov� / Incoming dpt.
110 00 Praha 1, Senov�n� n�m�st� 23, Czech Republic
Phone:+420-2-2414 2419    +420-2-2414 2759     +420-2-2414 2755     +420-2-2414 2633
Fax: +420-2-2414 2000     +420-2-2421 1524      
E-mail: Jarolimkova@PragueInternational.cz
Fiserova@PragueInternational.cz
Kucerova@PragueInternational.cz
Sedova@PragueInternational.cz
Bank connection: �SOB, Na p��kop� 14, 110 00 Praha 1
      Account No.: 0478418473/0300/ in CZK
      Account No : 0478418983/0300/ in EUR

NAME:    
COMPANY:    
Address:    
E-mail:    
TEL./FAX:    
Request: Accommodation incl. breakfast
Name of the hotel: (1st option)    
Name of the hotel: (2nd option)    
Arrival Prague:
(please indicate date and time/flight No.)		    
Departure Prague:
(please indicate date and time/flight No.)		    
Number of nights:    
Type of room:    
Price in CZK/EUR:    
Total price for accommodation:    
Other services:    
   
   
Way of payment: 1) bank transfer (kindly fax back the bank tranfer copy)
2) credit card (Mail Order)

AUTHORISATION LETTER OF A CREDIT CARD FOR MAIL ORDER:
If you wish to pay by Credit Card, kindly fill in this part of form and fax back with your signature.
Payments are net of bank fees. Bankhandling fees must be settled by participants.
DO NOT fill if want to send by email
Name of the card holder:    
Number of the card:    
CVC code:
Holder of VISA or MASTERCARD, 3 last numbers from the back of card 		   
Valid until:    
Amount:    
Date of mail order issue:    
Signature:     fill after printing
Cancellation conditions: 29 - 14 day prior arrival 100% of 1 night NO SHOW 100% for the whole stay
13 days and less 100% of 2 nights

Kindly, fax or (E-mail) completed forms to a.m. numbers latest by 1st April 2003.

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