Mediterranean cities and climate change

Marseille 27-28 June 2009

FR

REGISTRATION FORM - PDF Version :

Please complete and submit this application form
A confirmation email will be sent to you once you register.
The payment for your accommodation has to be sent to :


PROMO SCIENCES
7 Impasse Roqueplan
F-13002 Marseille

Tél. : +33-4-91-91-24-89
Fax : +33-4-91-91-76-83
E-mail : info@promosciences.com

Personal information :

Mr. Mrs Ms Prof. Dr         Fields marked with * are required.
Last Name *    Given / First Name *
Title
Affiliation / Institution / Company *
Postal Address *
Zip Code *       Town/City *
Country *
Telephone * (Please, include country code and area code)
Mobile Phone      Fax
E-mail *
ATTENDANCE * Consult the program

Saturday 27 june 2009

Sunday 28 june 2009
pm am
 cocktail (13h)
 
 

Food requirements
no pork
 vegetarian
 other
ACCOMMODATION *
 I need no accommodation
I wish to reserve the following accommodation
  single double deposit
to be paid
Category 4-star 190 € 220 € 200 €
Category 3-star 130 - 170 € 180 € 150 €
Category 2-star 100 - 130 € 110 - 150 € 120 €
 

Date of arrival
Date of departure
Number of nights

 - Price per room, per night, breakfast and taxes not included
 - The selected hotels are downtown. The rooms will be attributed on a first come first served basis. No reservation can be done if payment (one night deposit) is not received
 - Cancellation and refunding : the deposit will be refunded if cancellation is received in writing by June 10, 2009. After this date, no refunding will be possible.
PAYMENT (Accommodation)
  - Hotel bookings will be made when payment is received, in Euros.
 - All charges due to bank transfer or payment by cheque must be paid by the participant.

Cheque to the order of Promo Sciences   -   Credit Card
 Bank Transfer (Please send a copy)

Last update : 08/04/2009