HOTEL ACCOMMODATION REGISTRATION FORM - fresh

NAME
Title:
First Name:
Surname:
CONTACT DETAILS
Address:
Telephone (work): Fax:
Postal Code:
Email:
FLIGHT DETAILS
Date Of Arrival:
Flight Number:
Time:
Passport Number:
Nationality:
The above preferential rates expire on 12 March 2010 and cannot be guaranteed after this date.
To secure your reservation, we require your credit card details or full pre-payment.
CREDIT CARD
Visa Masters Diners Amex
Card No:
Expiry date: CVC number: (3 digits on back)
Cheques are not accepted
SIGNATURE
DATE
NAME SHARING
Title:
First Name:
Surname:
Date Of Departure:
Flight Number:
Time:
Passport Expiry Date:
DO YOU NEED TRANSPORT FROM THE AIRPORT TO THE HOTEL? YES NO
If yes, your hotel accommodation account will automatically be debited with the amount of EUR70.00.00 one-way transfer for
three people.
Please complete this form by 12 March 2010 and return directly to Natalia Agafonova
BANk TRANSFER
Bank: ZAO Raiffeisenbank
Branch: St. Petersburg
Branch code: RZBMRUMM
Account number: 40807978803000300519