logo72s.gif (5804 bytes) title.gif (3351 bytes)

 

Home Page

Welcome Note

International
Advisory
Board

Acknowledgements

General
Information

Social 
Program

Accompanying
Persons Program

Post Symposium Tour

Advanced
Program

List of Keynote Speakers and Lectures

Accommodation

Registration Form

Accomodation
& Tour Form

Abstract Form

Intention Form

 dot.gif (56 bytes)

 

Accommodation and Tour Form

Please complete and return form, together with your payment to:

KENES TOURS
PO Box 50006, Tel Aviv, 61500, Israel,
Tel: +972 3 514 0004
Fax: +972 3 514 0044 /514 0077
E:Mail: KTC@kenes.com

Identification
Please complete this section accurately; the information you provide will allow us to correspond with you efficiently.

Please TYPE IN BLOCK LETTERS

Field marked in red are required.

Participant
Surname
First Name
Middle Initial(s)
Title
Department
Institution
Mailing Address
No.
Street
Suite/Apt.
City
State/Province
Postal Code
Country
Telephone: (office hours)
Country code/city code/number
Fax:
Country code/city code/number
E-Mail:
Accommodation
Type of room required    Single     *Double     Other
Hotel
Check in date 
Check out date
Total night(s)
*I will share my accommodation with
Registered accompanying person's program
  No. of People
Arrabida & Palmela
Sintra / Colares / Cabo Roca
Pre and Post Symposium Tours
Classic Lisbon - Half Day Tour EURO 50
Evora - Full Day Tour EURO 100
Obidos / Nazare / Fatima - Full Day Tour EURO 100
Hotel Deposit
All requests for accommodation must be accompanied by a deposit of Euro 200 per room.
Please make cheque payable to Kenes Tours or charge deposit to credit card, as detailed below:
Visa  MasterCard  Diners 
Number
Expiration Date (month/year)
Name as shown on card:
Surname
First Name
Signature (printed form only) __________________________
 

This site was designed by