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Please
complete:
NAME:__________________________________________________________________________________________________
INSTITUTION:___________________________________________________________________________________________
ADDRESS:______________________________________________________________________________________________
CITY:_______________________________________________STATE/REGION:_____________________________________
COUNTRY:__________________________________________ZIP
CODE/POSTAL CODE:____________________________
EMAIL:_________________________________________________________________________________________________
PHONE:___________________________________________________________FAX:_________________________________
Registraiton
fee:
*
$425 if received before
June 15, 2002
*
$500 if received after
June 15, 2002
Please
check and complete:
We
accept checks and money orders only, made payable to: UC REGENTS
Send check or money order to Melinda Laraneta at:
UCLA, Department of Physics &
Astronomy, Los Angeles,
CA 90095-1547, USA.
MY
PAYMENT IS ENCLOSED: ____
MY
INSTITUTION IS SENDING PAYMENT: ____
*I
WILL PAY UPON ARRIVAL AT CHIA LAGUNA: ____ (450 Euros)
*Payment
at registration must be made in Euros and arranged in advance.
Please send your request to Melinda Laraneta: laraneta@physics.ucla.edu.
Hotel
Reservations:
The
Grand Hotel Chia Laguna is a full service hotel and resort. All
rooms are double rooms. The cost of your room at half board includes
breakfast and dinner; full board includes breakfast, lunch and
dinner. The cost of the rooms in Euros, including tax, is as follows:
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Double
Room with Half Board (Breakfast, Dinner):
115Eu x .88885 = $102.22/1.2* = $85.18/person/night
(pre tax)
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115.00 Euros
|
Double
Room with Full Board (Breakfast, Lunch, Dinner):
135Eu x .88885 = $120.00/1.2* = $100.00/person/night
(pre tax) |
135.00 Euros
|
Single
Room with Half Board (Breakfast, Dinner):
145Eu x .88885 = $128.89/1.2* =$107.41/night
(pre tax) |
145.00 Euros
|
Single
Room with Full Board (Breakfast, Lunch, Dinner):
165Eu x .88885 = $146.66/1.2* = $122.22/night
(pre tax) |
165.00 Euros
|
| *Value
Added Tax on hotel accommodations of 20%. |
Children
up to 12 (same room as parents): 50%, up to 2 years old free.
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Please
complete the following to reserve your room with Master
Card or Visa:
NUMBER
OF ROOMS: __________
NUMBER
OF GUESTS:_________
DATE
OF ARRIVAL: _________________ DATE OF DEPARTURE:______________
SPECIAL
NEEDS:________________________________________________________
CREDIT
CARD TYPE: ________________ EXPIRATION DATE:
_______________
CREDIT
CARD NUMBER:__________________________________________________
________________________________________________________________________
Signature
Please
Note: in case of a no show your credit card will be charged
with two (2) days of room charge. Reservation cancellations
after May 31st will be charged one (1) day room charge
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Please
select the bus of your choice and indicate the number of
passengers:
JUNE
30: Depart Cagliari Airport to G.H. Chia Laguna:
11:30 _____17:45 ____21:45 ____
NUMBER OF PASSENGERS: ____
JULY
06: Depart G.H. Chia Laguna to Cagliari Airport:
09:30 _____13:00
____
NUMBER OF PASSENGERS: _____
JULY
07: Depart Bus Departing Chia Laguna for Cagliari Airport
09:30 _____
NUMBER OF PASSENGERS: ______
I
DO NOT NEED BUS TRANSPORTATION: ____
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______________________________________________________________________________________________________
Signature
& Date
( Please make sure you have signed this document before faxing.)
Please
fax your completed form to Melinda Laraneta at + (310) 206-5251.
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