Last name: First name: Affiliation: Postal address: City: ZIP Code: Country: Phone: Fax: E-mail: WWW:
6200 FF (VAT 20.6% included)
640 FF per day x days = FF (VAT 20.6% included)
Banker's draft Post office Cheque (account CCP Paris 30041-00001-0909945 B O20-31) Bank transfer to the "Trésorerie Générale des Yvelines," Versailles (France), account number 10071-78000-00003003958-80
Arrival date and time Departure date and time Number of nights