The link for booking your accommodation is here EUROHAPTICS 2018 ACCOMMODATION FORM * compulsory field A.I.C. Asti Incentives & Congressi srl - Piazza San Uomobono, 30 - 56126 Pisa (Italy) Ph. +39 050 598808 - www.aicgroup.it PERSONAL DATA Last Name* First Name* Address* Postal Code* Town* Country* Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua And Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia And Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo, The Democratic Republic Of The Cook Islands Costa Rica Cote D'Ivoire Croatia (Local Name: Hrvatska) Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France France, Metropolitan French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Heard And Mc Donald Islands Holy See (Vatican City State) Honduras Hong Kong Hungary Iceland India Indonesia Iran (Islamic Republic Of) Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea, Democratic People's Republic Of Korea, Republic Of Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macau Macedonia, Former Yugoslav Republic Of Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States Of Moldova, Republic Of Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Kitts And Nevis Saint Lucia Saint Vincent And The Grenadines Samoa San Marino Sao Tome And Principe Saudi Arabia Senegal Seychelles Sierra Leone Singapore Slovakia (Slovak Republic) Slovenia Solomon Islands Somalia South Africa South Georgia, South Sandwich Islands Spain Sri Lanka St. Helena St. Pierre And Miquelon Sudan Suriname Svalbard And Jan Mayen Islands Swaziland Sweden Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania, United Republic Of Thailand Togo Tokelau Tonga Trinidad And Tobago Tunisia Turkey Turkmenistan Turks And Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Venezuela Vietnam Virgin Islands (British) Virgin Islands (U.S.) Wallis And Futuna Islands Western Sahara Yemen Yugoslavia Zambia Zimbabwe Vat Number / Tax Code (SSN/SIN)* C.F. (Fiscal code for Italian participant)* Phone* Fax Email address* HOTELS (NO SHUTTLE PROVIDED, CITY TAX NOT INCLUDED): BREAKFAST INCLUDED PISA CITY TAX: According to the City Council resolution N° 56 of December 21st 2011, since 1st March 2012 Pisa introduced a CITY TAX, applied to NON residents overnight staying, for a maximum of 3 consecutive nights during the low season and for a maximum of 5 consecutive nights during the high season. The tourism tax for 4* hotel is € 2,00 per night per person, for 3* hotel is € 1,50 per night per person to be paid at the check-out. PLEASE NOTE • All rates are in Euros, per room per night and include overnight and breakfast; • Rooms will be allocated on a first come, first served basis; • Credit card data will be requested as guarantee upon booking confirmation; total payment is due directly to the hotel and invoices will be issued directly by the hotels • No reservation will be guaranteed for requests arrived after 20th April 2018. After this date availability will be requested; • A voucher as confirmation will be sent to all participants by AIC srl two weeks before the beginning of the Congress; CANCELLATION POLICY • Any change or cancellation must be sent in written to AIC srl (fax +39 050 0987825 // e-mail hepatology2018@aicgroup.it • Within 20th April 2018: no amount will be charged on your credit card • After 20th April 2018: first night rate will be charged on your credit card as penalty No show: reservations will be automatically cancelled and the total amount for your stay will be charged on your credit card HOTEL Hotel (1st choice) Hotel (2nd choice) Arrival date: Day Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Month Month January February March April May June July August September October November December Year Year 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 1917 1916 1915 1914 1913 1912 1911 1910 1909 1908 1907 1906 1905 1904 1903 1902 1901 1900 Departure date: Day Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Month Month January February March April May June July August September October November December Year Year 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 1917 1916 1915 1914 1913 1912 1911 1910 1909 1908 1907 1906 1905 1904 1903 1902 1901 1900 Total nights: Room type DUS room DBL double room with... TWN twin room with... Total Amount due First night as guarantee Balance METHOD OF PAYMENT (First night as guarantee) AND (as balance) directly to the hotel Method* VISA MASTERCARD Card Number* Exp. Date* insert month and year expiration date CVV Code* CVV code: last 3 numbers behind your credit card Cardholder* I hereby attach copy of bank transfer of (First night as guarantee) File upload Browse... Maximum size 10MB This field should be left blank Send Please wait... EUROHAPTICS 2018 ACCOMMODATION FORM * compulsory field A.I.C. Asti Incentives & Congressi srl - Piazza San Uomobono, 30 - 56126 Pisa (Italy) Ph. +39 050 598808 - www.aicgroup.it PERSONAL DATA Last Name* First Name* Address* Postal Code* Town* Country* Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua And Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia And Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo, The Democratic Republic Of The Cook Islands Costa Rica Cote D'Ivoire Croatia (Local Name: Hrvatska) Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France France, Metropolitan French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Heard And Mc Donald Islands Holy See (Vatican City State) Honduras Hong Kong Hungary Iceland India Indonesia Iran (Islamic Republic Of) Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea, Democratic People's Republic Of Korea, Republic Of Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macau Macedonia, Former Yugoslav Republic Of Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States Of Moldova, Republic Of Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Kitts And Nevis Saint Lucia Saint Vincent And The Grenadines Samoa San Marino Sao Tome And Principe Saudi Arabia Senegal Seychelles Sierra Leone Singapore Slovakia (Slovak Republic) Slovenia Solomon Islands Somalia South Africa South Georgia, South Sandwich Islands Spain Sri Lanka St. Helena St. Pierre And Miquelon Sudan Suriname Svalbard And Jan Mayen Islands Swaziland Sweden Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania, United Republic Of Thailand Togo Tokelau Tonga Trinidad And Tobago Tunisia Turkey Turkmenistan Turks And Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Venezuela Vietnam Virgin Islands (British) Virgin Islands (U.S.) Wallis And Futuna Islands Western Sahara Yemen Yugoslavia Zambia Zimbabwe Vat Number / Tax Code (SSN/SIN)* C.F. (Fiscal code for Italian participant)* Phone* Fax Email address* HOTELS (NO SHUTTLE PROVIDED, CITY TAX NOT INCLUDED): BREAKFAST INCLUDED PISA CITY TAX: According to the City Council resolution N° 56 of December 21st 2011, since 1st March 2012 Pisa introduced a CITY TAX, applied to NON residents overnight staying, for a maximum of 3 consecutive nights during the low season and for a maximum of 5 consecutive nights during the high season. The tourism tax for 4* hotel is € 2,00 per night per person, for 3* hotel is € 1,50 per night per person to be paid at the check-out. PLEASE NOTE • All rates are in Euros, per room per night and include overnight and breakfast; • Rooms will be allocated on a first come, first served basis; • Credit card data will be requested as guarantee upon booking confirmation; total payment is due directly to the hotel and invoices will be issued directly by the hotels • No reservation will be guaranteed for requests arrived after 20th April 2018. After this date availability will be requested; • A voucher as confirmation will be sent to all participants by AIC srl two weeks before the beginning of the Congress; CANCELLATION POLICY • Any change or cancellation must be sent in written to AIC srl (fax +39 050 0987825 // e-mail hepatology2018@aicgroup.it • Within 20th April 2018: no amount will be charged on your credit card • After 20th April 2018: first night rate will be charged on your credit card as penalty No show: reservations will be automatically cancelled and the total amount for your stay will be charged on your credit card HOTEL Hotel (1st choice) Hotel (2nd choice) Arrival date: Day Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Month Month January February March April May June July August September October November December Year Year 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 1917 1916 1915 1914 1913 1912 1911 1910 1909 1908 1907 1906 1905 1904 1903 1902 1901 1900 Departure date: Day Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Month Month January February March April May June July August September October November December Year Year 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 1917 1916 1915 1914 1913 1912 1911 1910 1909 1908 1907 1906 1905 1904 1903 1902 1901 1900 Total nights: Room type DUS room DBL double room with... TWN twin room with... Total Amount due First night as guarantee Balance METHOD OF PAYMENT (First night as guarantee) AND (as balance) directly to the hotel Method* VISA MASTERCARD Card Number* Exp. Date* insert month and year expiration date CVV Code* CVV code: last 3 numbers behind your credit card Cardholder* I hereby attach copy of bank transfer of (First night as guarantee) File upload Browse... Maximum size 10MB This field should be left blank Send Please wait...
