/ EAMT04
MALTA, 26-27 April, 2004
ACCOMODATION FORM

Personal Details

First Name / Surname / Title
Address
Country / Organisation
tel / fax / email

Accommodation Details

Arrival Date / Departure Date
No. Nights / Accom. Type
(all prices Euro)
Hotel / Location / Single / Tick / Double / Tick
Corinthia Marina 5* / St. George’s Bay, Sliema / 100 / 112
Victoria 4* / Sliema / 68 / 95
Sliema 3* / Sliema / 40 / 55
Osborne 3* / Valletta / 50 / 72
Total Accommodation Payment / Euro:

N.B. These prices are guaranteed until 08/03/2004. If you have special requirements (e.g. multiple bookings for different lengths of time), please use more than one form or otherwise indicate overleaf.

Special Requirements

Gozo Mini-Stay

Arrival Date / Departure Date
No. Nights / Accom. Type
(all prices Euro)
Hotel / Location / Single / Tick / Double / Tick
Grand Hotel* / Mgarr Gozo / 75 (65) / 92
(80)
Cost (figure in parenthesis applies if staying three days or more). / Euro:

Optional Excursions

A / Tick / Blue Grotto, Hagar Qim & Mnajdra / Sunday 25th
Afternoon / 20 Euro
B / Tick / Three Cities / Wednesday 28th Morning / 20 Euro

Banquet: (please also email Mike Rosner with subject “interested in banquet”)

Tick if interested (payment later) / Xara Palace, Mdina / Monday 26th
Evening / c. 55 Euro

Payment

Accommodation Cost
Mini Stay Gozo
Excursions
Total

¨  Credit Card

Type (please tick)
¨  Visa
¨  Mastercard / Card No.
Expiry Date / Total Amount
+4% surcharge for use of credit card
Total
I authorize payment of the total amount above
Signature of Card Holder Date

¨  Direct Bank Transfer to

HSBC Bank (Malta) plc
32 Merchant Street
Valletta VLT 10
Malta / Account Name Foundation for International Studies,
Account No. 0330 7556 5050
Swift Code MMEB MT MT
IBAN:
MT 18 MME B44 336 0000000 330 75 56 50 50

Important if paying by bank transfer:

¨  Ensure reference “EAMT04” is quoted with payment.

¨  Enclose copy of bank transfer order with this form.

Please return this form, to: Ms. Lucienne Bugeja, Foundation for International Studies, University of Malta, St. Paul Street, Valletta VLT07, Malta. Fax: +356 2123 0551, tel. +356 2123 4571, email

page 1/3