Booking form for ITPA Monte-Carlo Meeting – March 15–17 2009 – Hôtel Hermitage [pdf version]
Please print, tick the appropriate circle, complete and post/fax to:
Elizabeth Husband, ITPA Convention Bureau, PO Box 134, Sevenoaks, Kent TN15 6SZ, UK
Telephone: +44 1732 746688 Fax: +44 1732 746689 e-mail: elizabeth@itpa.org
O I am a member of the ITPA. Please register me for the Monte-Carlo Meeting
O I am NOT currently a member of the ITPA. Please register me for the Monte-Carlo Meeting and enrol me as a member of the ITPA
O I am not a member of the ITPA and would like to apply for Guest membership. I am attending my first ITPA meeting in the company of: .....................................................................who is an existing ITPA member. Please register me for the Monte-Carlo meeting
Declaration by new members
My work is concerned with or includes the theory or practice of international tax planning or the study thereof but is not concerned with and does not include in the normal course (whether or not as the employee of any government) levying taxes of any kind in any part of the world (Rule 4(i) of the Association). I understand that the Committee has power to grant or refuse this application, but without being required to disclose any reason. I also understand that the Association is a company limited by guarantee and, if it became insolvent, I might be liable to contribute a maximum of one Cayman dollar (US$1.20). Provision has been made below to include the enrolment fee and my annual membership subscription. I understand that both this and the booking fee will be returned to me in full should my application not be accepted.
NAME :
FIRM :
ADDRESS :


Tel :
Fax :
e-mail:
O I should like to have the set lunch / vegetarian* option
O I shall be accompanied by my spouse.
O My spouse would like an invitation to the set lunch provided for members on 16 / 17* March and would like to have the set lunch / vegetarian* option
His / her* name is: ................................................................................................... His / her* e-mail address is:
...................................................................................................
COST
Attendance fee - applicable to bookings made and paid for after 15th January 2009 £1250
Early booking Attendance fee - applicable to bookings made and paid for before 15th January 2009 £1150
Non-members only: Enrolment & annual membership subscription fee. Please add: £510
PAYMENT METHOD [1. Credit card / 2. Cheque]
Credit cards will be debited in sterling. Payment may also be made by a sterling cheque drawn on a UK bank. If you wish to pay by cheque in a currency other than sterling, please ask the Convention Director to tell you the corresponding amount.
*1. Please charge the cost of attendance / cost of attendance and membership* £.............................. to my VISA/AMEX/Diners/MasterCard* in the name of: 
...................................................................................................
Card No.                                    
Expiry date:      /    
Sec. code:        
last 3 digits on signature strip ( AMEX cardholders please use 4 digits above card number)
OR
*2. A sterling cheque drawn on a UK bank for £............................, being the cost of attendance /cost of attendance and membership* in favour of the ITPA, is attached / is in the mail*
ACCOMMODATION
O Please reserve me a standard room at the Hôtel Hermitage for .......... nights from ........... March 2009. I shall settle all my hotel bills directly with the hotel. The rate per room per night, including buffet breakfast, is €299
O Please reserve me a seaview room at the Hôtel Hermitage for .......... nights from ...........March 2009. I shall settle all my hotel bills directly with the hotel. The rate per room per night, including buffet breakfast, is €329
O I do not require a hotel reservation
 
 Signature.................................................................................................. Date....................................
* delete as required itpaweb/31dec2008
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