<p> Hotel Booking Form</p><p>3rd -5th February 2016</p><p>Please fill out the reservation request form below, we will send you the Confirmation detailing the bookings, terms & payment via e-mail within 24 - 48 hours * required field</p><p>The Duke Hotel Rates: Special rate Single room € 99, 00 Double Room single use classic € 109,00 Double Room Classic € 114,00 Double Room single use superior € 144,00 Double Room Superior € 139,00 Deluxe Room € 159,00 Junior Suite € 199,00 Suite € 219,00</p><p>Above rate is quoted in Euro (€), it is per night, per room, it includes The Duke American buffet breakfast, 10% VAT and service charge. It excludes the City Tax of € 6,00 to be paid in hotel. The rates also include: -complimentary 7-seat Mercedes transfer to Accademia del Belgio (Congress Venue) (to be booked in advance at Front Office) -complimentary 7-seat Mercedes transfer to Piazzale Flaminio/Piazza del Popolo -use of Wi-Fi free of charge </p><p>Surname : * Name: * Address : City : * Country : * Tel. Number : Fax. Number : </p><p>E-mail : * Please check again if your email address is correct</p><p>The Duke Hotel Via Archimede 69, 00197 Roma – Tel. +39 06 367221 – Fax +39 0636004104 Email: [email protected] H o t e l B o o k i n g D e t a i l s</p><p>Check-in date : dd/mm/yy Check-out date : No. of nights </p><p>Room Type required: </p><p>No. of Adult No. of Children Occupancy : Single Double bed Twin bed</p><p>PLEASE CONFIRM BOOKING VIA: FAX: +39 06 36722706 OR E-MAIL: [email protected]</p><p>The rates are subject to availability. </p><p>General Conditions:</p><p>-The preferred rates are guaranteed for reservations received until 20th December 2015. After that date, rates may be subject to change. -Reservation are on a first-come, first served basis -Booking Forms will be taken into consideration upon availability of rooms and rates -Cancellations at no penalty must be received 72 hours before date of arrival -In case of no show or early departure the whole cost of reservation will be charged -In order to guarantee the reservation the hotel requires copy of Your Credit card (front & back).</p><p>Any additional information or requirements ( i.e. other pax names, children age etc ):</p><p>______</p><p>CREDIT CARD DETAILS</p><p>Amex: Visa: Diners: Mastercard: JCB </p><p>Credit card Number</p><p>Expiry date</p><p>Signature</p><p>The Duke Hotel Via Archimede 69, 00197 Roma – Tel. +39 06 367221 – Fax +39 0636004104 Email: [email protected] Date ______</p><p>The Duke Hotel Via Archimede 69, 00197 Roma – Tel. +39 06 367221 – Fax +39 0636004104 Email: [email protected]</p>