String Pheno '09
                          June 15 - 19, 2009
                           Warsaw, Poland
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          String Pheno '09  reservation form  -  Hotel METROPOL
                      deadline: May 20, 2009
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  FAMILY NAME: _____________________________________________________

  FIRST  NAME: _____________________________________________________

  INSTITUTION: _____________________________________________________

      ADDRESS: _____________________________________________________

       E-MAIL: _____________________________________________________

        PHONE: _____________________________________________________

          FAX: _____________________________________________________


   Please book me a  ___ Single room with breakfast (325 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 Metropol
                                  ul.Marszalkowska 99A
                                  Warszawa, Poland

   Fax: +48-22-3189889            Tel: +48-22-3182888
   E-mail: centralreservation@syrena.com.pl 
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