The following questionnaire will help you to make your needs clear to us. You will receive our estimate within 48 hours. Should we need any further information in order to provide you a detailed estimate, we shall contact you.  Required dates  :   Please specify your chosen date(s) and times.  Type Number of persons  Congress  Seminar  Conference  Cocktail  Show  Christmas party  Fashion shows  Showroom  Other (specify)  Welcome coffee    Break    Buffet    Cocktail    Other : (please  specify)  Study days - fixed rate including : Room hire - coffee on arrival - two breaks - buffet lunch or dinner.  Title Madame Mademoiselle Monsieur  Surname *  First name  Corporate name  Address  Postal code  Town  Country  Telephone *  Fax  E-mail * * Obligatory  Are you already a customer at the Espace Saint-Martin ?   Yes No  How did you hear about the Espace Saint-Martin ?  Guide book (which one ?)  Telephone book    Word of mouth    Internet    Advertisement (which one ?)  Press article (in which  publication ?)  Other : (please  specify) In compliance with the French Data Protection Act of 6 January 1978 (section 34), you have the right to access, modify, correct or suppress data about yourself.