Hotel & Excursions Reservation Form
10th International Conference of Shallow 
Level Centers in Semiconductors
Warsaw, Poland, 24-27 July 2002

Deadline: 20th May 2002

Please complete this form using CAPITAL LETTERS and send to:
First Class Travel Agency
5 Nowowiejska Street, 00-643 Warsaw,  Poland
or to fax +48-22-825-95-81 
or to e-mail: kongres@firstclass.com.pl
 
Title: 		Prof. 		Dr.		 Mr. 		Mrs. 		Ms.	
............................................................................................…………………………….
First name	Middle Initial	Last Name
Affiliation   ..........................................................................…………………………………………..
(Dept. Univ. or Company)
Mailing address:      ......................................................................…………………………………….
Street
................................................................................................................………………………………
Country 	Postal Code	 City
Tel.:
 (include country and area code)	Fax:
 (include country and area code)	e-mail:	

HOTEL	Sgl	Dbl	
Marriott	172 USD	182 USD	
Europejski	95 EUR	123 EUR	
Grand	84 EUR	102 EUR	

Hotel prices include breakfast and taxes.
Your hotel booking will be accepted only upon receipt of the payment of hotel deposit equivalent to one night at the chosen hotel. Hotel deposit will be credited to your hotel bill.
Cancellation!
The participant that informs the First Class Travel Agency about hotel reservation cancellation (in writing or by e-mail), prior to 20th May 2002 will receive reimbursement of the hotel deposit diminished by 
10 USD of the handling charge. After this date deposits are not refundable.

Please book the hotel:
First choice		
Second choice		

	single room		double room (to share with: ..................................................................)	

	 number of nights	

Check-in date		Check-out date		

EXCURSIONS	Date of excursions	Number of persons	Cost	
Warsaw & Royal Castle Sightseeing
50 EUR per person	Thursday, 25 July 2002
(10.00 – 14.00 hours)			
Piano Concert in Żelazowa Wola
95 EUR per person	Saturday, 27 July 2002
(9:00 – 14:30 hours)			
TOTAL AMOUNT				

This excursions require a minimum number of participants. You will be notified and refunded by First Class if the required minimum number of bookings has not been achieved by 20th June  2002.   

PAYMENT	USD	EUR	
Hotel deposit			
Excursions			
TOTAL			

Total amount will be paid as follows:
	 By Bank transfer to:	
        SAZ S.A. First Class Travel Agency
        BRE BANK  S.A. Warsaw Branch, 18, Senatorska Str. , 00-950 Warsaw, Poland
        Account number: 11401977-00-262953-PLNCURR 01-62                  

Please indicate on the transfer “SLCS-10”.
Please note that the bank account for hotel payment is DIFFERENT from that for registration fee.  All bank charges must be paid by the participant. 
If  the  remitter’s  name  differs  from the participant’s name,  please state clearly the name   
of the  participant.

OR
By credit card:		Visa		Eurocard / Mastercard		Diners		American Express	

When  the hotel deposit payment is made by credit card, the form should be sent to the First Class Travel Agency by post or fax (not e-mail).   

Card         number																	

Cardholders name		

	 DD	MM 	YY 	
Expiration date							

Date		Signature		

NO CHEQUES WILL BE ACCEPTED