First Name:
Last Name:
Address:
City:
Country:
E mail:
Home Phone :
Office Phone :
Arrival Date :
Departure Date :
Type of Room
2 Queen Bed
(2 persons max) $115/ Night
1 Queen Size Bed
(2 persons max) $105/ Night
1 King Size Bed
(2 persons max) $115/ Night
Extra person $20/ Night,
1
2
3
4
5
Total No. of Person :
Credit Card Information
Name of Card :
Select
Visa
Mastercard
Card No. :
Exp. Date :
Any extra Note if you want to give: