<p> VICH 4 Conference – “VICH Impact and future expectations”</p><p>ACCOMMODATION BOOKING FORM</p><p>NOTICE - All hotel reservations must be made through the “Centrale Hôtelière Élysées Hôtels” - Please provide ELYSEES HOTELS with all the required information to ensure a valid reservation. The credit card number can guarantee your reservation. - The VICH Secretariat is not responsible for the reservations. In case of questions related with your accommodation reservation, please contact Élysées Hôtels directly.</p><p>Please return your booking request to ELYSEES HOTELS by May 31, 2010 at the very latest. Contact: Angelo Correia ([email protected]) (Hours: 9h - 19h from Monday to Friday) - Tél : (33) 1 47 75 40 86 - Fax : (33) 1 47 75 92 99</p><p>In reply ÉLYSÉES WEST RESERVATIONS will automatically send you confirmation with the full address of the hotel booked. To cancel or modify your reservation, please contact EWR by fax or by e-mail. In the event of failure to take up the reservation, the hotel will charge you for the first night.</p><p>Name: First name: Organisation: Country: Tel: Fax: Email: </p><p>Date of arrival: Date of departure: Number of rooms: Number of people: Number of nights: Credit card #: Card type: Expiration date: </p><p>ROOM  Single  Double  Twin </p><p>DISTRICT  OIE area  Opera area  Latin quarter </p><p>RATES PER NIGHT  80 to 100 euros  101 to 120 euros  more than 121 euros</p><p>Please refer to the list of hotels mentioned in the Conference General Information - If you have a preferred hotel, please give the name and address: </p><p>……………………………………………………………………………………………………………</p><p>MODIFICATION / CANCELLATION Cancellations made 3 days or more before the arrival date: no charge. Cancellations made less than 72 hours before arrival will incur a charge equivalent to the room rate for 1 night. All changes must be made directly with ÉLYSÉES HOTELS and not the hotel. Modification/cancellation is taken into account only if it is written on a paper (letter, fax) or sent by e-mail.</p>