Send or fax this part of the form direct to:

Send or fax this part of the form direct to:
"THE HOLIDAY INN LONDON-NELSON DOCK"
HOTEL RESERVATION FORM EUROMEDIA '96 CONFERENCE
December 19-21, 1996

All reservations have to be made before November 15th, 1996
in order to ensure your room availability

Name (last, first):

Company / affiliation:

Mailing address: [ ] Home or [ ]Business









Postcode:
City:
Country:

Telephone:
Fax:
E-mail:

Other: [ ] I am vegetarian [ ] I am a non-smoker

Room rates are £ 90 for a single room and £ 115 for a double room.

Please Reserve: _______ Single rooms and _______ Double rooms
Date of arrival ___________ Time of arrival:______________ Date of departure:_____________

HOTEL RESERVATION DEPOSIT
The Holiday Inn London, Nelson Dock can only confirm your reservation request when accompanied by credit card data or one night deposit (room rate). This deposit may be made by cheque, or any major Credit Card. If paying by cheque, please include date on the face of the check. Refunds will be made when the cancellations are received no less than fifteen (15) days prior to your scheduled arrival date (be sure to keep your cancellation number).

Or pay by CREDIT CARD:

Charge my (tick one) [ ] Visa [ ] Euro/Mastercard [ ] American Express [ ] Diners

Card number: Expiration date:

.....................................................

Authorizing Signature

SENDING THE REGISTRATION FORM

Please, send this filled-in form together with cheque to:
Holiday Inn London, Nelson Dock, 265 Rotherhithe Street
SE16 1EJ, London, United Kingdom
Tel: +44.171.231.1001, Fax + 44.171.231.0599

Name (last, first):
Company / affiliation:
Mailing address: [ ] Home or [ ]Business




Postcode:	City:	Country:
Telephone:	Fax:	E-mail:
Other: [ ] I am vegetarian [ ] I am a non-smoker