Client
Information:
Name on Credit Card:
______________________________________________________
Address1:______________________________________________
Address2:______________________________________________
Apt# :_______
City:___________________________________
State:_____________
Zip:_________
Country:________________________
E-Mail: (very important)
_____________________________________________________
Telephone
:___________________________________________
Fax: (very important)
__________________________________________________
Card: [Visa __] [M/C
__] [A/E __] [DS __]
Card# __ __ __ __ __ __ __ __ __ __ __ __ __
__ __ __
expiry date : ______/_____
Signature:_________________________________________________
(Required for credit card orders)
Type of apartment | Arrival
Date Departure Date | How many people
_________________|_____________________|_____________|___________
_________________|_____________________|_____________|___________
_________________|_____________________|_____________|___________
_________________|_____________________|_____________|___________
Special requests:
_____________________________________________________
_____________________________________________________
|
