Application for a lunch

Fields marked with * are required!

Project*

Required

Number of persons for 1-st day*

Names

Number of persons for 2-nd day*

Names

Number of persons for 3-rd day*

Names

Number of persons for 4-th day*

Names

Contacts

Phone number*
(including area code)

Required

E-mail*

Required

Contact person*

Required

Additional info

Form of payment*

Select Form of payment

Payment details will be sent to you by E-mail

Please, fill in the fields below

Name of Company*	Required
Full address*	Required
Beneficiary account*	Required
Beneficiary’s bank*	Required
SWIFT*	Required

Authoritzation letter will be sent to you by e-mail. Please, return the filled letter with a photocopy of your credit card (both sides) by fax +7 (495) 721-88-66 or by e-mail: hotel@mediexpo.ru. The photocopy of your credit card will be provided to our bank as guarantee of transaction's security. We do not accept: Visa Electron, MasterCard Maestro.