Reservation Request Form

HOTEL PLAZA ROSALES

Name Of Person Mr./Ms Mr./Ms Mr./Ms Mr./Ms Mr./Ms Mr./Ms Company Contact person E-mail address Tel Room Type Standard Single Room Standard Twin Room Deluxe Twin Parlor Suite Corner Suite Internet Access Laptop Taking With Lancard
Venue(Room,BQ Room)

Check In Date Check Out Date First name

Last name

Nationality

No. of Room

No.of Person

Smoking/ Non Smoking Breakfast

Special request

Credit Card # Expire Date Name of Card holder

5549 2740 0895 6979 10/2016 Maria de Lourdes Cardoso Valente

Remarks/ Special Request

RSVN #

TARJETA REGISTRO/REGISTRATION CARD

Name Home Address Ciudad/City Pasaporte/Passport/C.I Correo Electronico Nmero Habitacin Nmero Reserva

Last Name

Estado/State Nacionalidad/Nationality Fecha de Nacimiento

Check In

Check Out

______________________ Firma/Signature

Forma de Pago Contra Factura (convenio comercial) Efectivo Tarjeta de crdito Nmero

Vencimiento

Cheque Nmero En Caso de requerir factura: Razn Social Giro Domicilio Banco

Pas/Country

cha de Nacimiento Nmero Pasajeros

Tipo Habitacin

Cdigo Autorizacin

Sucursal

Rut Telfono