Surname:

First Name:

Title:

Institution:

Hospital:

Department:

No:

Street:

City:

State:

Country:

Postal Code:

Tel:

Fax:

Cell Phone:

E-mail:

Hotel	Single	Double*	Check in**	Check out**
Makedonia Palace (city view)	170 €	190 €	....../..../2008	....../..../2008
Makedonia Palace (sea view)	190 €	210 €	....../..../2008	....../..../2008
Mediterranean Palace	170 €	185 €	....../..../2008	....../..../2008

The rates are per room, per night and include buffet breakfast.
*   I will share my accommodation with:

Surname:

First Name:

In case the first choice category is fully booked please notice that we will arrange a reservation in the next category hotel available.
Room reservations will be given first priority.

Transfer Service

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Arrival:

Date:

Airline/Flight :

At Hours:

Departure:

Date:

Airline/Flight :

At Hours:

Please arrange arrival transfer and departure from "Macedonia" Airport to hotel and from hotel to "Macedonia" Airport:

by private car at additional cost of € 35,00 per way (up to 3 pax)

Tours

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Please check the appropriate box/es.

Tours	Time	Rate per person	Date	Number of seat/s
CITY TOUR	09.00-14.00	-	27/09/08

Tours	Time	Rate per person	Date	Number of seat/s
VERGINA	09.00-17.00	60 €	28/09/08
MOUNT ATHOS	07.30-18.30	100 €	28/09/08

** Check in and Check out dates must be in format: day/month

Way of payment

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Payment for accommodation and tour provided by Carlson Wagonlit Travel is payable to Carlson Wagonlit Travel.
Deposit: 50% of the total accommodation

Please indicate amount enclosed and ensure that you send 50% of the total hotel accommodation deposit with your accommodation form completed.
Deposit: € ....

The hotel reservation cannot be confirmed until the registration form has been received by the Secretariat of the Symposium.

Please also sent the completed accommodation form to the Secretariat of the Symposium by fax or email.

Option 1

Bank: ALPHA BANK
No: 128/00-2002-00-2799
IBAN: GR70 0140 1280 1280 0200 2002799
SWIFTCODE : GRBAGRAA
All bank charges should be paid by the participant.

- Bank transfer payable to Carlson Wagonlit Travel, stating your name.

Option 2

CANCELLATION POLICY

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Cancellations received by June 24^th, 2008, full refund less bank charges.
Cancellation received by July 24^th, 2008, 50% of total hotel accommodation will be charged.
Cancellations received later than July 24^th, 2008, 100% cancellation fees.

I Agree