PARTICIPANT Title: *Mr/Mrs/Ms/Miss   Dr/Prof. (male/female)  *ring/underline

First name: ................................................ Last name: ..............................................................................

Organisation: ..............................................................................................................................................
 

Address: ....................................................................................................................................................

City: .......................................... Country: .......................................... Postal code: ....................................
 

Phone: ......................................... Fax: ................................. E-mail: ........................................................
 

ACCOMPANYING PERSON/S:  *ring/underline

First name: *Mr/Mrs/Ms/Miss .................................... Last name: ................................................................

First name: *Mr/Mrs/Ms/Miss .................................... Last name: ................................................................
 

HOTEL SPECIAL RATES: in EUROS per person, per day (breakfast is included)
These apply for registered EWSII participants & accompanying persons only

Hotel Croatia:   Double room: 57 (sv)   49.5 (pv)   Double room 'solo use': 108 (sv)   94 (pv)

Hotel Supetar:  Double room: 26 (pv)   Double room 'solo use': 43 (pv)

City tax is not included in price: EUROS 0.8 (approx. KN 5,50) per person, per day
Please tick/underline/ring clearly your room of choice with its daily rate (sv = sea view  pv = park view)

Total number of nights stay: ..................... From .......................................... To ...........................................
Total cost (Incl. city tax) in EUROS: ......................................
For pre/post stay the hotel will charge same special symposium rate
 

HOTEL MINIBUS SERVICE (local airport):

Date of arrival: ........................................ Flight number: ......................Time: ...............................................

Date of departure: ................................... Flight number: ......................Time: ...............................................
 

CONFIRMATION OF PAYMENT: Deadline for hotel reservation is by Wednesday 25th August 2004;
after this date reservation will be accepted on a rooms-available basis only, but at the Hotel full rates.

A guarantee via credit card or a deposit of 100 Euros per room is required.
No room can be confirmed until hotel receives its deposit or credit card information.

CANCELLATION POLICY: There is no refund for cancellation after deadline.
 

Payment Option A: Guaranteed by credit card*:  Amex/ Diners/ Master/ Visa   *ring/underline

Credit card number: ...................................................... Expiry date: .........................................
Name on card: ................................................................................ Signature: ...........................................
 

Payment Option B: Bank Transfer:

Bank details: PRIVREDNA BANKA ZAGREB, Rackoga 6, 10000 ZAGREB, Croatia
Account name: HOTELI CROATIA d.d. CAVTAT  
Account number: 70010 - 978 - 134087    SWIFT: PBZGHR2X

Please add the following: The 2nd European Whitefly Symposium 2004
Net payment should be done in EUROS. Participant's name must be clearly specified
 

PLEASE RETURN YOUR COMPLETED FORM TO:

Post mail: HOTEL CROATIA, Frankopanska 10, 20210 CAVTAT, Republic of Croatia
Fax: +385 (0) 20 478 213   E-mail: info@hoteli-croatia.hr   Telephone: +385 (0) 20 478 055