Name: Street:

City : .. Postal code: Country:.........

Telephone:

Fax: ....

E-mail:

Object (1):

Double rooms: 0 1 2 3

Triple rooms:... 0 1 2 3

Object (2):

Double room: ... 0 1

Triple room:....... 0 1

Fourfoldrooms: 0 1 2

Date of departure: ............ Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Month I II III IV V VI VII VIII IX X XI XII Year 2003 2004 2005

Remark: