Name and Surname:

Thematic Work Group number:

University:

e-mail:

Travel Data Arrival

Date:

Time: Hour Minutes
AM
PM

Airline:

Other (e.g. train, bus):

Travel Data Departure

Date:

Time: Hour Minutes
AM
PM

Airline:

Other (e.g. train, bus):

Meal attendance Confirmation

Vegetarian?

Nights for hotel accommodation

Room Type

Please note:
Cliohres will pay only for single accommodation for official members for the above nights.
If you wish to stay extra days or have a double room to share with a partner, relative or friend; you will need to arrange for this and pay the extra charge (see below)

Nights?

Pre payment by credit card is required.
Please contact golemtour@email.cz

Name(s):

Nights?

Meals?