| Guest name : |
*
Mr.
Ms. |
| Guest nationality : |
* |
| Flight arrival date : |
|
| Flight departure date : |
|
|
PERIOD
1 |
| Number of guests : |
Adults,
Children under 12. |
| Number of rooms : |
room(s):
extrabed(s):
|
| Room type : |
Breakfast |
| Check in date : |
|
| Check out date : |
|
| Number of nights : |
|
|
PERIOD
2 ( for any change during your stay) |
| Number of guests : |
Adults,
Children under 12. |
| Number of rooms : |
room(s):
extrabed(s):
|
| Room type : |
Breakfast |
| Check in date : |
|
| Check out date : |
|
| Number of nights : |
|
|
COMMENTS |
|
|
|
| Card type : |
AMEX Not accepted ! |
Card
number : |
Write by hand
on the printed fax form |
| Expiration date (mm/yy): |
/
|
| Cardholder's name : |
* |
| Cardholder's adress : |
* |
| E-mail address : |
* |
| Confirm E-mail address
: |
* |
| Telephone : (Including
country & area codes) |
* |
| Fax : (Including
country & area codes) |
* |
|
Price : |
Write by hand
on the printed fax form |
Signature : |
Write by hand
on the printed fax form |
Date : |
Write by hand
on the printed fax form |
** Extrabeds are generally free for children
under 12.
* required information |