Reference Name:Ecologic Institute/ Water Conference

Reservation FormNH Hoteles

REFERENCE NAME:ECOLOGIC INSTITUTE/ WATER CONFERENCE

REFERENCE BOOKING NUMBER:175154872

Block dates:23/05/2012 – 25/05/2012

Cut off date: 23/04/2012

O MrO Mrs

Last name: ______First name:______

Date of arrival: Date of departure:

Hotel Name:NH DU GRAND SABLON

Rue Bodenbroek 2/4
1000 Brussels

Standard Room 23/05:

O Single room€ 150.00 per room, per night

O Double room€ 175.00 per room, per night

Standard Room 24/05:

O Single room€ 130.00 per room, per night

O Double room€ 155.00 per room, per night

Breakfast is included.

These rates are net and include services, taxes and VAT and are per night and per room.

CANCELLATION FREE OF CHARGE UNTIL 5DAYS PRIOR TO ARRIVAL

PAYMENT METHOD

OPayment by Guest

We kindly ask you to guarantee the reservation by credit card in order to secure the room for you in case of late arrival. Any non-guaranteed rooms will be released at 4pm.

Guarantee by credit card:

O VisaO MastercardO Diners Club

O EurocardO American Express

Credit Card holder:______

Credit Card Nbr :______

Expiration Date :____/____

In case of no show the owner of the card authorizes the hotel to charge the credit card for the total stay.

CONFIRMATION

Please mention your email address or fax number should you wish to receive a confirmation of your reservation;

email: ______

fax number: ______

Please return the reservation form to . The above rates are valid until 23/04/2012.After the above dates the rooms will be automatically released. And if guests would like to add rooms after this date, it will be subject to availability and the same price can’t be guaranteed anymore.

Please return this form to the reservation department:

Brussels Booking Office

Fax. + 32 2 518 1299

Tel. + 32 2 214 09 02