16TH International Workshop on Vascular Anomalies

16^TH International Workshop on Vascular Anomalies

ACCOMMODATION FORM

Rooms will be allotted on a “first come first served” policy

Reservation made by (name & surname) ______________________________

E-mail address to send hotel voucher _________________________________

Hotel	Options	HOW MANY DOUBLE ROOMS?	HOW MANY DOUBLE FOR SINGLE ROOMS?	IN DATE	OUT DATE
Park Hotel Hyatt *****	Option for 10 rooms
Hotel Spadari ********	Option for 10 rooms
Grand Hotel Plaza ********	Option for 80 rooms
Hotel dei Cavalieri ********	Option for 50 rooms
Una Hotel Cusani ********	Option for 25 rooms
Hotel Gran Duca di York *******	Option for 10 rooms
Hotel Santa Marta *******	Option for 20 rooms
Hotel Vecchia Milano *******	Option for 20 rooms
Hotel Speronari *	Option for 10 rooms

Accommodation reservations are not confirmed until credit card details are provided to be passed on to the hotel as guarantee.

You will pay the balance of your account directly to the hotel.

credit card VISA_____ MASTERCARD_____ AMERICAN EXPRESS______

name of card holder __________________________________________________

Signature of card holder ______________________________________________

Card number _____________________________Expiry date ______________

Please send complete credit card details only by fax to the number +39(0)30.40164