RESERVATION FORM

In order to reserve a room in the Hotel please fill the following form and transmit it to us.

Nom Last Name Email
Telephone Fax Mobile
Address    
City    
Postal Code Country
Hotel    

Arrival Date

Date Month Year
Departure date Date Month Year

Number of Persons :

Adults Children Number of rooms

Room Type

Remarks

Confirmation: by Fax by e-mail

Mode de paiement
 

Credit Card     Money Transfer
Number of Credit Card  
Date d'expiration /  
Name credit card holder  
Code  
The code number consists of three numbers in the back of your credit card and is by the holder’s signature

If you prefer not to provide us your credit card number on the Internet, please print the above form and transmit it by: +30-210-6234423
( Date .. /.. /.... , Signature ................ )