PLANCK'07 Tenth European Meeting
                          June 9 - 13, 2007
                           Warsaw, Poland
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               PLANCK'07  reservation form  -  Hotel HARENDA
                      deadline: March 31, 2007
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  FAMILY NAME: _____________________________________________________

  FIRST  NAME: _____________________________________________________

  INSTITUTION: _____________________________________________________

      ADDRESS: _____________________________________________________

       E-MAIL: _____________________________________________________

        PHONE: _____________________________________________________

          FAX: _____________________________________________________

     (TYPE AN  "X"   IN THE SPACES CORRESPONDING TO YOUR CHOICE)


   Please book me a  ___ Single room with breakfast (220 PLN/day)

                 ___ Double room (double bed) with breakfast (270 PLN/day)

   Date of arrival:   _____________ at __________ o'clock  
 
   Date of departure: _____________

   The credit card to guarantee my reservation:

       ___Visa   ___Eurocard  ___Mastercard  ___American Express 

       Credit card number: _____________________________________

       Credit card name:   _____________________________________

       Security Number:    _____________________________________

       Expiry date (e.g. 11/07):  ____/____



       Signature:  _____________________________________________
          
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   Print and send by fax to       Hotel HARENDA
                                  ul. Krakowskie Przedmiescie 4/6
                                  PL-00-331 Warszawa, Poland

   Fax: +48-22-8262625            Tel: +48-22-8260071
   E-mail: rezerwacja@hotelharenda.com.pl
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