Fifth International World Wide Web Conference

May 6-10, 1996 - Paris, France

Hotel Reservation Form

Please print and fill in this form. Then mail or fax it before April 26, 1996, to :

Fifth International WWW Conference - c/o CTM
4, place de Saverne - Cedex 106 - 92971 La Défense - FRANCE
Tel: +33 (1) 41 16 64 53 - Fax: +33 (1) 41 16 65 99

First Name: ____________________________ Last Name: _______________________

Company/Organization: ____________________________________________________
Address: ________________________________________________________________
City: ________________________ State/Province: ______________________________
Zip/Postal Code: _____________ Country: ______________________
Company Phone: ______________________ Company Fax: ______________________

Email Address: ____________________________________________________________

Please indicate your choice of hotel:
1st ____________________________________________________________
2nd ____________________________________________________________
3rd ____________________________________________________________
Single room: ____ Double room: ____ . Smoking: ___ Non Smoking: ___

Arrival Date: ____________ Departure Date: ____________ Total number of nights: _______

If you are interested in this reservation service, please provide us with a credit card number to guarantee your hotel reservation, no reservation will be made without it:

|_|Visa |_|American Express |_|Eurocard |_|Master Card |_|Diners
Card holder: _____________________________
Card number: _____________________________ Card Expiration date (Month/Year): ____/____

 


Signature: __________________________ Date: _________________