Student`s room booking form - Namur

 Student’s room booking form (one form per room) Date : ………………………………………………….. Name: ……………………………………………………………………………………………………………………………………………………… First name: ………………………………………………………………………………………………………………………………………………. Email address: …………………………………………………………………………………………………………………………………………. Student’s room: €35.00/per night Breakfast: €10.00/day I would like to book a student’s room from ……………………………(date) to ………………………………….. (date). □ I will have breakfast at the University restaurant. □ I want to book a room alone I will pay €……………………………... (total price) together with my registration fee. Signature: Buffet Breakfast including coffee, tea, fruit juice, a choice of fruit, various sweet breads, cheese, ham and marmalade, served at the self‐service restaurant of the University, which is 5 minutes away from the student’s residence. Reminder: The deadline (booking and payment) for reduced registration fee is 21 June 2013. Université de Namur – ECAART 11 – c/o Karin Derochette – rue de Bruxelles, 61 – 5000 Namur Tel + 32 81 72 54 76 – Fax + 32 81 72 54 74 – Email : info@ecaart‐11.be ‐ website : www.ecaart‐11.be