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ESA Telecom Information Day 12/13 April 2006 ESA/ESTEC Noordwijk Netherlands HOTEL RESERVATION FORM To be returned as soon as possible to ESTEC Hotel Reservation Service P. O. Box 299 2200 AG Noordwijk The Netherlands tel* 31-71 5658030 / fax 3184 224 8628 e-mail estec*hoteldesk esa*int Family Name. Initials. Organisation/Agency. Mailing Address. Country. Telephone. Fax. E-mail. Wishes to reserve a room in a hotel of Please tick the appropriate box Category A Single Euro 115 -180 including breakfast. Single Euro 80 -110 including breakfast. Single Euro 50 - 80 including breakfast. Date of arrival. Date of departure. In order to guarantee your reservation please indicate below your credit card details Credit Card number. Name. Expiry date. Cancellation policy Cancellation within 24hours before arrival equivalent of 1 night will be charged Participants should pay the bill directly to the hotel on departure. O. Box 299 2200 AG Noordwijk The Netherlands tel* 31-71 5658030 / fax 3184 224 8628 e-mail estec*hoteldesk esa*int Family Name. Initials. Organisation/Agency. Mailing Address. Country. Telephone. Fax. E-mail. Wishes to reserve a room in a hotel of Please tick the appropriate box Category A Single Euro 115 -180 including breakfast. Initials. Organisation/Agency. Mailing Address. Country. Telephone. Fax. E-mail. Wishes to reserve a room in a hotel of Please tick the appropriate box Category A Single Euro 115 -180 including breakfast. Single Euro 80 -110 including breakfast. Single Euro 50 - 80 including breakfast. Date of arrival. Date of departure. Single Euro 80 -110 including breakfast. Single Euro 50 - 80 including breakfast. Date of arrival. Date of departure. In order to guarantee your reservation please indicate below your credit card details Credit Card number. In order to guarantee your reservation please indicate below your credit card details Credit Card number. Name. Expiry date. Cancellation policy Cancellation within 24hours before arrival equivalent of 1 night will be charged Participants should pay the bill directly to the hotel on departure. O. Box 299 2200 AG Noordwijk The Netherlands tel* 31-71 5658030 / fax 3184 224 8628 e-mail estec*hoteldesk esa*int Family Name. Initials. Organisation/Agency. Mailing Address. Country. Telephone. Fax. E-mail. Wishes to reserve a room in a hotel of Please tick the appropriate box Category A Single Euro 115 -180 including breakfast. Single Euro 80 -110 including breakfast. Single Euro 50 - 80 including breakfast. Date of arrival. Date of departure. Initials. Organisation/Agency. Mailing Address. Country. Telephone. Fax. E-mail. Wishes to reserve a room in a hotel of Please tick the appropriate box Category A Single Euro 115 -180 including breakfast. Single Euro 80 -110 including breakfast. Single Euro 50 - 80 including breakfast. Date of arrival. Date of departure. In order to guarantee your reservation please indicate below your credit card details Credit Card number. Single Euro 80 -110 including breakfast. Single Euro 50 - 80 including breakfast. Date of arrival. Date of departure. In order to guarantee your reservation please indicate below your credit card details Credit Card number. Name. Expiry date. Cancellation policy Cancellation within 24hours before arrival equivalent of 1 night will be charged Participants should pay the bill directly to the hotel on departure.

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