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Accomodation form for residence for students



 
 

  • IDENTITY   Mr Mrs Miss   (Check with an X)
Name : First name :
Organization :
Address :
 
Postcode : City : Country :
Telephone : Fax :
Email :
 
  •  STUDENT RESIDENCE RESERVATION
I wish to make a reservation in a residence for students : 
85 FF per night (breakfast in addition)
 For the night of :   For :  
 8 june 1999 1 person
 9 june 1999
10 june 1999
Total :

 Date of arrival :  Expected hour of arrival to the residence : 

 Date of departure : 
 Transport : CAR TRAIN AIRPLANE

 
  •  PAYMENT
Enclose this reservation with a cheque for the sum of :
85 FF per night make out in French Francs to "INSA".

If this reservation is not confirmed for the expected date, and except for a cancelling 48 hours before,
deposit will be lose and reservation cancelling will be definitive.

  Please find enclosed our postal or bank cheque
   on :

 
 Print this reservation form, and post it before the 17 may 1999 to (don't forget the cheque) :

Madame REGNIER
INSA
20, avenue des Buttes de Coësmes
35043 RENNES Cedex
Telephone : +33 2 99 28 65 67 - Email : Marie-Anne.Regnier@insa-rennes.fr