RESERVATION FORM

NAME

( 25 Char. )

TELEPHONE

( 16 Char. )

ADDRESS

( 25 Char. )

 FAX NUMBER

( 16 Char. )

CITY-STATE

ZIP CODE

( 16 Char. )

E-MAIL

Yourname@domain.com

ACCOMMODATION DATA

ARRIVAL DAY

DEPARTURE DAY

ADULTS

0 1 2 3 4 5 6 7 8

CHILDREN

0 1 2 3 4 5 6 7 8

MAIN BUILDING

Choose your preference Standard Junior Suite 2nd flloor Junior Suite 3rd floor Apartment

DELUXE BUILDING

Choose your preference Apartment 1st floor Suite 2nd flloor Master Suite 3rd floor All the building

CREDIT CARD DATA

NUMBER

( 16 Char. )

EXPIRED DATA

DD/MM/YYYY

IS A

Visa
Master Card
Amex

SECURITY NUMBER

( 16 Char. )

OTHER

( 20 Char. )

OWNER'S NAME

( 25 Char. )

OPTIONAL DATA

How did your hear about our hotel

 ( 150 Char. )

Comments or special needs

 ( 150 Char. )