Air2003 International Meeting on Alphya1-Antitrypsin Deficiency

Air2003 International Meeting on Alpha1-Antitrypsin Deficiency
Barcelona, June 11-13 2003.

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HOTEL REGISTRATION FORM

HOTELS

Please fill in this form and return it by fax together with your payment to the meeting secretariat.

HOTELS	DOUBLE ROOM	DOUBLE ROOM SINGLE USE
H. GRAN MARINA HOTEL 5* G.L.	323 €	303 €
H. NN UNIVERSAL 4*	190 €	155 €

(Breakfast and VAT are included)

HOTELS ACOMMODATION

NAME SURNAME

HOTEL: ROOM:

ARRIVAL DATE: DEPARTURE DATE:

PAYMENT BY CREDIT CARD

As safety measure, if you wish to pay by credit card, we recomend you to fill and sign in the form bellow and send it to us by fax.

CREDIT CARD: (VISA, MASTERCARD) EXPIRY´S DATE:

TOTAL AMOUNT IN EUROS

SIGNATURE

PAYMENT BY BANK TRANSFER

If you wish to pay by bank transfer, we please to send a copy by fax with the registration form.

The account number is:

SWIFF CODE BSAB ES 1
BANC DE SABADELL
0081 0381 99 0001101515

TECHNICAL SECRETARIAT:

BCM
C/ Balmes, 74 1º 1ª
08007 Barcelona
TEL 34 93 318 57 34
FAX 34 93 342 41 47
airmeeting@bcmedic.com
www.bcmedic.com/airmeeting