RANDOM '98 HOTEL RESERVATION FORM ---------------------- Name: __________________________________________________________ Affiliation: __________________________________________________________ Address: __________________________________________________________ Postal Code: ____________ City: ______________ Country: _______________ Phone: _____________ Fax: ______________ ROOMS RATES (in Spanish Ptas., breakfast and taxes included) HOTELS CAT. TWIN SINGLE (1) HOTEL ARENAS **** 12.519.- 10.593.- (2) HOTEL LUNA *** 17.120.- 11.770.- (3) HOTEL BEL AIR *** 10.105.- 7.135.- REQUIRED RESERVATION Hotel (Give two numbers in order of preference): ________________ Type of room: ____________________ Accompanying person (if also attending RANDOM '98): ____________________ Find a roommate for me, if possible (Y/N): ___ Sex (M/F): ___ Date of arrival: _______________ Date of departure: ________________ IMPORTANT NOTES 1) Availability is limited. ONLY BOOKING REQUESTS RECEIVED BEFORE SEPTEMBER 5TH 1998 CAN BE GUARANTEED. 2) NO BOOKING REQUEST WILL BE ACCEPTED without corresponding deposit payment (minimum one night). 3) On receipt of this Form and Deposit Payment, we will send you a Hotel Voucher indicating the amount paid, which will be deducted from the Hotel bill. PAYMENT 1 - Bank draft in Pesetas (Ptas.) payable to ULTRAMAR EXPRESS by a Spanish Bank. 2 - Bank transfer to BANCO SANTANDER (c/o ULTRAMAR EXPRESS), Branch nr. 0202, Ramblas, 74 08002 BARCELONA. Acc. nr. 0085.0202-58.0000011210 Transfer fees to be paid by you. Please attach draft or photocopy of transfer to this form. 3 - Credit Card (Visa,AX,DC) Card Nr.: ____________________________________ Exp. Date: _____________ Name of Cardholder: ___________________________ SEND THIS FORM TOGETHER WITH PAYMENT TO ULTRAMAR EXPRESS Universitat Politecnica de Catalunya c/ Jordi Girona, s/n Campus Nord 08034 - BARCELONA Ph. (34-93) 280.53-46 Fax. (34-93) 204.97.55 Date: ________________________ Signature: _____________________ (Authorized signature if using Credit Card)