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HOTEL RESERVATION FORM Dear Guest,

You are kindly

requested to complete this form (using capital letters) and return it at your earliest convenience but before 25 May 2016 A limited number of rooms have been blocked by the organisation. Reservations are accepted on 'first come, first serve' base.

Please note that

your r equest c an only b e c onsidered a definit e booking, after you have receiv ed a confirmation from hotel T his form cannot be used to register for the conference itself. T o:

E-mail:

Name of Congress: B e h a v i o u r a l I n s

i g h t S A B E I A R E P

Surname: First name:

Male Female Initials: Titles: Company:

E-mail: Address: Postal code: City / Town:

Country: Phone number:

Fax number: A

bout the accommodation

All hotel rooms are non

-smoking and have private bathroom facilities with toilet and shower. Rooms are

equipped with a television and telephone. Hof van Wageningen offers wireless internet, free of charge.

Ho tel prices

(excluding breakfast (€ 12,50), excluding € 1,29 local taxes p.p.p.n. (subject to change)) € per room per night Single room:

Twin room : € 70,00 per room per night R equested accommodation:

Single room Nr of rooms

Twin room Nr of rooms Nr. of persons

Arrival date - - 2 0 1 6

Departure - - 2 0 1 6

Total night(s):

W ay of payment: C ash /Pin EuroCard/MasterCard

Visa American Express

Card number: - - - Expiry date: /

Card holder"s name:

Signature:

Y

our remarks: ...............................................................................................................

P lease mention your credit card number for the confirmation and guarantee of your reservation.

You may pay upon arrival, cash or by credit card.

By signing this document you accept the hotel booking and cancellation conditions mentioned in this form.

B ooking and cancellation conditions (applicable to individual hotel reservations)

Booking conditions:

*Room s are allocated on a 'first come, first served' base. A limited number of rooms are reserved for this meeting. *B ookings for this meeting will only be accepted through this hotel reservation form. *Reservation forms, received after the date mentioned above, will be handled. However, accommodation cannot be guaranteed, bookings are accepted on availability. * Without a credit-card guarantee, an advanced deposit is required. F

OR YOUR CONVENIENCE, MAKE A COPY OF THIS FORM!!!

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