| First Name: |
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| NAME: |
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| Address: |
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| Zip code: |
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| City: |
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| COUNTRY: |
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| Phone: |
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Fax: (if available) |
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| E-mail: (if available) |
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Date of
arrival:
(DD/MM/YYYY) |
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Hour of arrival:
(roughly) |
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| Type of room: |
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Number of night(s): |
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Type of payment: |
Comment: (if you wish more than one room
for example) |
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Euro Cheque
Cheque
Holidays
Master Card
CB
VISA
American
Express |
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