2004 IEEE INSTRUMENTATION AND MEASUREMENT TECHNOLOGY CONFERENCE IMTC 2004 HOTEL RESERVATION FORM Please, type clearly! Last/First Name______________________________________________________________ Organization_________________________________________________________________ Mailing address _____________________________________________________________ _____________________________________________________________________________ City/State/Country/Postal Code_______________________________________________ Phone________________________________________________________________________ Fax__________________________________________________________________________ Email _______________________________________________________________________ Please, reserve the following accommodations: Number of Rooms Room and Hotel Type If reservation is received up to 31 MARCH 2004 If reservation is received from 1 APRIL 2004 o No. ___ single occupancy in a 4* hotel 120.00 Euro 138.00 Euro o No. ___ double occupancy in a 4* hotel 160.00 Euro 184.00 Euro o No. ___ triple occupancy in a 4* hotel 180.00 Euro 207.00 Euro o No. ___ single occupancy in a 3* hotel 100.00 Euro 115.00 Euro o No. ___ double occupancy in a 3* hotel 130.00 Euro 149.50 Euro o No. ___ triple occupancy in a 3* hotel 150.00 Euro 172.50 Euro o No. ___ single occupancy in a 2* hotel 80.00 Euro 92.00 Euro o No. ___ double occupancy in a 2* hotel 100.00 Euro 115.00 Euro o No. ___ triple occupancy in a 2* hotel 120.00 Euro 138.00 Euro Cross the preferred accommodation and insert the number of rooms that you are reserving for each type (otherwise, one is assumed for each cross). Room rates are per night and include buffet breakfast. Confirmation will contain the name and the address of the hotel in which the rooms have been reserved. Arrival date and approximate time:___________________________________________ Departure date and approximate time:_________________________________________ Number of nights:____________________________________________________________ Reservation must be guaranteed by credit card. Card Type (cross one): o MasterCard o VISA o American Express o Diners Credit Card # _______________________________________________________________ Expiration date _____________________________________________________________ Card Holder _________________________________________________________________ Signature______________________________________________Date__________________ Cancellations will be accepted without penalties if performed before 10 May 2004. Cancellation received from 11 May 2004 are subject to a charge equal to the total amount due for whole reserved period (i.e., the number of reserved night times the daily rate of the reserved room). Send the completed hotel reservation form to the hotel reservation service at Grand Hotel di Como by fax to +39-031-516-600 (attn. Mr. Michele Toncelli) or by email to meeting@grandhoteldicomo.com or manag2@grandhoteldicomo.com