Radiology International Inc.

  HOTEL REGISTRATION - BARCELONA

Enclosed is our payment in the amount of $1,000 per room representing deposit for the Radiology Conference in Barcelona. Cancellations of land arrangements will result in a $200 per room administrative fee in addition to penalties that may be imposed by the hotel and ground operator. There will be no refund on cancellations received on or after August 03, 2009. By completing this form, we acknowledge and accept all the terms and conditions of the conference.

E-mail Address:

Full Name:

Additional Persons:

Address:

City, State/Province - Postal Code - Country

Home Telephone Number

Fax Number

Business Telephone Number

For questions please email Globe Travel Service (click here to email) or call 800 942 4080.

  Room Rates:  Physician Rate Single room $2,965   2nd person: $695.00

Included: Breakfast, service charges, taxes and arrival coach transfers as shown in the Land & Air Plan
Supplementary prices for Junior Suites and Suites available from Sylvia, Claudia or Denise. 860-584-9197 or 1-800-942-4080 (Toll Free in theU.S.A.)  
NOTE: Prices may change if there is significant fluctuation in the exchange rates.

If you have any special needs please note here.

A deposit of $1,000 per room is required. The balance is due August 03, 2009.

Payment Method

Card # or Check #

Exp. Date

Authorized  Signature      Security Code        

Total $ Enclosed

I am interested in information regarding: Pre- and Post-Conference Tours    Air     Car Rental     Insurance     

To pay by check or money order, please print and mail along with your check or money order made payable to:  

Globe Travel Service
225 North Main Street Suite 80
Bristol, CT USA 06010

860-584-9197 or 1-800-942-4080 (Toll Free in the U.S.A.) To pay by credit card, please print this form and mail or fax to:
Globe Travel Service, at the above address or fax to 860-585-6364.