PLANCK'07 Tenth European Meeting
                        June 9 - 13, 2007
                          Warsaw, Poland
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  PLANCK'07(81169)reservation form  -  Hotel IBIS Warszawa Stare Miasto
                    deadline: April 30, 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 (267.30 PLN/day, incl. breakfast)

                  ___ Double room (2 beds)(292.50 PLN/day, incl. breakfast)
              
         (in both cases reduction -54.00 PLN on Saturdays and Sundays)

   Date of arrival:   _____________ at __________ o'clock  
 
   Date of departure: _____________
   
   The credit card to guarantee my reservation (no charge if cancelled 
   at least 21 days before the arrival date):

       ___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 IBIS Warszawa Stare Miasto
                                  ul. Muranowska 2
                                  PL-00-209 Warszawa, Poland

   Fax: +48-22-3101010            Tel: +48-22-3101000
   E-mail: H3714-RE@accor.com
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