Reservation / Information Request Form

First Name*:

Last Name*:

Email address*:

Street Address:

City:

State/Province:

ZIP (Postal code):

Country:

Phone (home):

Phone (business):

Extension:

Fax (home):

Fax (business):

Arrival Date:

Departure Date:

Room type:

Choose your room type Room Single Room Double Studio Apt Apt. 2 bedroom Bung. 2 bedroom

Number of persons:

Payment Options :

Credit Card  -->  Choose credit card type American Express Mastercard/Eurocard Visa

Traveller Cheques

Cash

Other (please specify)