CUG SUMMIT 2000

Hotel Reservation Fax Form

Grand Hotel Huis ter Duin
Koningin Astrid Boulevard 5 - Postbus 85
2200 AB Noordwijk aan Zee - The Netherlands
Tel. +31 (0)71 - 361 9220 - Fax +31 (0)71 - 364 9150
(If the Fax number above is busy or fails to connect, you may try: +31 (0)71 - 361 9401)

Please FAX this reservation form (one form for each room reserved) to the hotel. Requests for reservations must be received by April 26, 2000 and must be guaranteed with a deposit for one night or with an accepted credit card.

First name: ___________________________Last name: ___________________________________________

Organization: _________________________Address:________________________________________ ______

City: _______________State: ____________Mail/Zip Code: _____________Country: __________________

Phone: _____________________Fax: _____________________E-mail address: ________________________
(Please include the country code, city or area code and the number)

Rate: Double room for single occupancy, including international breakfast buffet and including City Tax (Dfl 1,75 p.p.p.n.) Dfl. 346,75 per night, incl. VAT; accompanying person: add. Dfl. 30,- plus Dfl. 1,75 per night.

Preferred: (Please tick preference)

____Double room, single occupant____Double room: two occupants_____Smoking____Non-smoking

Sharing room with: __________________________________________________

Special requirements: (e.g. hearing, vision, diet, a room with two beds) ____________________________________________

Arrival: Date: _______________Time: _____________ (local Dutch time) Flight number:________________
Check-In Time: 3:00 PM

Shuttle Service: If required, please use the Shuttle Reservation Fax Form (to be found on this website).

Departure: Date: ____________Time: ____________(local Dutch time) Check-Out Time: 12:00 PM

Method of payment*:

_____MasterCard______Visa_____American Express_____Diner's Club

Credit Card Number***: _____________________________Expiration Date: ____________

Cardholder Name: ____________________________________ Signature: ________________________
*** We would appreciate it if you could also fax us a copy of the front and back of your credit card.

_____Check or Money Order**_____Traveller's Check**

_____Bank Transfer: Bank name________________________Account no.: ___________________________

Account name: _____________________________________Attendee name: __________________________
* Please make payments in Dfl (Dutch Florins).
** Make check or money order payable to Grand Hotel Huis ter Duin and send it to the address above. Please do not send currency.

Fax registration Date:________________________City: ________________________