APPLICATION

I wish to take part in the Focus on Europe event at Prague and Zlín 2004

First name................................................................................................Surname................................................................................................

Cinema......................................................................................................................................................................................................................

Address:....................................................................................................................................................................................................................

Telephone:....................................................................................................Fax:.....................................................................................................

E-mail:.........................................................................................................................................………………..

Mobile: ................................................................

TRAVELLING

I shall be travelling by

• Car
• Train
• Air

I have booked the following flights:

FLIGHT TO PRAGUE

Date........................................................................................................... Arrival time........................................................................................

Airport of departure................................................................................. Flight no....................................................

N.B.: On 3 June a shuttle service has been arranged from Ruzyne airport (Prague) to the hotel in Zlín. The service is expected to be available approximately in the late morning and early afternoon.

DEPARTURE FROM PRAGUE

Date........................................................................................................... Departure time................................................................................

Airport of arrival........................................................................................Flight no...............................................................

I ask MEDIA Salles to reserve for me a:

• single room
• double room

  for no................................nights, arriving on................................. and departing on................................

I acknowledge that MEDIA Salles will cover the cost of accommodation (3 nights per person and all meals from supper on the 3rd to breakfast on the 6th of June 2004) for the first 40 applicants and will provide a fixed sum towards travelling expenses.

Accompanying guests, who will be accepted according to the availability of rooms in the hotel, will be asked to pay a lump sum of 320 euros in a double room.

The cost of any rooms booked but not occupied will be charged to the cinema.

DETAILS OF THE GUEST

First name................................................................................Surname................................................................................

Date..................................................………… Signature…………………………………………….

We inform you that article 4 of MEDIA Salles' Statute foresees that:
"the members of the Association are distinguished by their having active membership, affiliated membership or auxiliary membership [.…]
Affiliated membership is extended to European cinema theatre management enterprises for the duration of their participation in the initiatives of MEDIA Salles [….]".

We kindly ask you to sign in the acceptance of this provision. We inform you that the membership to MEDIA Salles for the cinemas that participate in the "Focus of Europe at Zlín-Prague" is free and is valid from the 1st June to the 31 December 2004.

Please write the full name of the cinema that will become member of MEDIA Salles for the above-mentioned period:

………………………………………………..

Signature…………………………………….

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