Modulo Conferma Prenotazione - Hotel Village Eden

Reservation Form

To reserve, fill the following form, print out with the browser printing botton, then sign and send it by fax to 0039 0963 193 0189.

- GUEST

Surname:

Name:

Address:

Zip Code:

City:

State/Province:

Country:

Tel:

Fax:

E-mail:

- ACCOMODATION

Typology:

Arrangement:

From:

To:

Total Nights:

Adults (from 13 years old):

Children (4-12 years old):

Children (0-3 years old):

Note:

Arrival Time:

- EXTRA CHARGE

Baby Bed:

(35 Euro per week)

Transfers:

- ADVANCE DEPOSIT 30%

I enclose the Payment Order of 30% (Euro ) headed to HOTEL VILLAGE EDEN - Daisy srl - Loc. Grotticelle - 89866 Ricadi (VV) IBAN: IT 06 V 01030 40960 000001090083 - SWIFT: PASCITM1VVR

I authorize the "Hotel Village Eden" to withdraw the 30% of amount from my Credit Card:

Type:

VISA

MASTERCARD

Card Number:

Expiry Date:

Euro (digits):

In Letters:

Owner:

Authorized Signatory:



Date	Signature ________________________