MEDITERRANEAN RESERVATION REQUEST FORM

PERSONAL INFORMATION

Last name:

First name:

Click below to verify
Certificate Identity.

Address:

City:

State/Province:

Country:

Post/Zip code:

Your e-mail:

Tel: Home or Office ONLY (incl. area code):

Fax no:

Mobile/Cell/Handy number:

We call mobiles ONLY in extreme emergencies.

TRAVEL INFORMATION
Indicate Check-in & Check-out dates. (Click on the calendar image for help)

Arrival: Month>		Arrival: Day>	If more than 180 nights, please indicate in Comments
Departure: Month>		Departure: Day>	Number of Nights:


		Age of Children:>

Children 24 months old or less are FREE. Over 24 months but less than 12 years old pay only 50% of adult rate.

--- COMPLETE THE SECTION BELOW, ONLY IF YOU ARE CONFIRMING A RESERVATION ---

This is a Secure Server and all data is processed using 128 bit encryption. Therefore, we can only accept confirmed reservations if the information below is completed in full.
`Visa/Eurocard` `Mastercard` Name on card:
Credit Card number: Expiry date: ^*CVV/CVC :
* (Last 3 digits on the back of your card, at the right of your signature)
Please note: If your reservation is accepted, 50% of the total cost will be charged now and balance just before arrival day. We will send you a RESERVATION CONFIRMATION within 24 hours at the most, except on weekends.

Comments: Please type any comments, other type of rooms or special instructions below.

By submitting this form, I declare that I have read and agreed with the Terms & Conditions as described here.

NOTE: All fields indicated in red must be completed. * Check out time for all
accommodations is 12:00 noon. Therefore, we do not count the departure
since you will leave the room before 12:00 noon.