5-th Mountain Bike Orienteering World Championship

PRESS AND EXTRA REPRESENTATIVES
 ACCREDITATION FORM

To be filled IN BLOCK CAPITALS by Country Federations.
Must be submitted till May 31th, 2007 to WOC MTBO 2007 office:
Czech orienteering federation, Zatopkova 100/2, 160 17  Praha 6, Czech republic
or by e-mail: csob@cstv.cz

Title:		

Name:		

Phone:		      Fax:		

E-mail:		

Address:		

Type of media:
	Journalist			Photographer			TV			Radio			Extra representatives	

Arrival date:		         Departure date:		

Accommodation:
Accomodation	Number of 
persons		Unit price	Total price	
Single room in SKI HOTEL		x	385 EUR		

Payments have to be carried out by May 31th 2007 by means of:
Beneficiary: Český svaz orientačního běhu, Zátopkova 100/2, 160 17 Praha 6
Beneficiary s Account No.: CZ7606000000001716809504
Beneficiary s Bank: GE Money Bank, Vítězné náměstí 2, 160 00 Praha 6
Bank Identification Code: AGBACZPP
All bank fees must be paid by the sender. Entries will not be valid until we receive the full payment.

Requirements:		

Other:		

Date:		             Signature: