Accommodation Form

14th Annual Meeting of the Baltic Sea Network on Occupational Health and Safety

(2nd of October)

and

Forum "Research for the Evidence Based Policy, Decisions in Public Health and Occupational Health"

dedicated to the 200 years anniversary of the Institute of Hygiene

(3rd of October)

Vilnius, 2008

IMPORTANT: fields, marked *, are compulsory

Name*

Last Name*

Organization*

Address

Phone

Fax

E-mail*

Arrival Date & Time (YYYY/MM/DD HH:MM)*

Departure Date & Time (YYYY/MM/DD HH:MM)*

Room type*

		Single (82 Euro)
		Double (87 Euro)

Roomshare

Special requests

IMPORTANT INFORMATION:

The hotel room prices are in Euro per room per night. The room price includes breakfast and 5% VAT

After 8th of September, 2008, hotel Artis (the venue) is not guaranteed for accomodation. If you do not get confirmation or any other information in two days after registration, please contact the Forum Secretariat Conbaltas by e-mail: doloresa@balticconference.com.

PAYMENT

Payment is made directly to the hotel upon check-out.

Please, provide your credit card information with regard to accommodation. It will be used towards the hotel as well as to Conbaltas to guarantee your room reservation. In case of no-show, arrival after the reserved date, or departure before the reserved date and cancellation, Conbaltas or the hotel may charge your credit card with the amount corresponding to the full stay requested.

For the security reasons, please fill the form below and fax it to the Forum Secretariat Conbaltas +370 5 212 0013.
To download the Credit Card Details Submission Form press here - CC Details Submission Form. Do not send this form by email!