Bleibtreu Hotel Berlin
Member of design hotels™

Win one of five prolonged weekends at the Bleibtreu Hotel
Double room. 3 Nights. 3 Days. Friday. Saturday. Sunday. (Breakfast included)
Fill in the form.
Closing date: 31.07.2004. The course of law is excluded.

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Personal Details

Please fill in the form with your correct personal details to win a weekend:

:: Last Name*		:: First Name*
:: Gender*	Select Gender Female Male	:: Birthday	[Month DD YYYY]
:: Profession*		:: Company*
:: Street*		:: Number*
:: City*		:: State/Province
:: ZIP*		:: Country*
:: Phone		:: Fax
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* These entries are necessary and need to be completed.