JUNE 28-30, 2001 Villa Olmo Quantum Computers and Quantum Chaos

Accomodation Form

(PLEASE TYPE OR WRITE IN BLOCK LETTERS - ONLY ONE FORM PER PARTICIPANT)

to be sent before 28th May 2001 to Chiara Stefanetti (fax +39.031.573395 - email: stefanetti@icil64.cilea.it)


 
Family Name First Name(s)
University Department
Address City
Country Sex ... M ... F
Fax (office) E-Mail
Arrival date Departure date

Hotel prices (Euro. min./max.) - may increase 5% in 2001


 
category
single room
double room
breakfast
****
85 / 100
120 / 140
Incl.
***
65 / 80
90 / 105
Incl.
**
50 / 65
70 / 80
Incl.

Please, reserve : ? single room ? double room to be shared with _____________________________

in a: ? **** ? *** ?**

A deposit corresponding to the amount of Lit. 100.000 per person is requested.

... I?m sending the amount of Lit. _________________ by Bank Transfer on:

Banca Regionale Europea S.p.A.

Filiale di Como - Viale Giulio Cesare, 26/28

Account Nr: : 3655/0 (ABI 6906 - CAB 10900)

Account Name: Centro di Cultura Scientifica "A. Volta"

Please, send a copy of money order.

... Communicate my credit card info to the hotel as guarantee of my reservation (no charge):

...Visa ...Mastercard ...Eurocard

Card n. __________________________________________ Expiry Date ______________________

Cardholder __________________________________ Signature ____________________________

\N.B. Reservation is not guaranteed after May 28th 2001.

No refund of deposit will be made without a written cancellation (by e-mail or fax) after June 11th Date _____________________ Signature_______________________________

Form to be sent to: Centro "A.Volta" Secretariat

Villa Olmo, Via Cantoni 1

22100 Como (Italy)

fax +39.031.573395 - e.mail: stefanetti@icil64.cilea.it