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FullName:_______________________________________________________________________
Address1:_______________________________________________________________________
Address2:_______________________________________________________________________
City:____________________________________________________________________________
State:___________________________Zip/PostCode:___________________________________
Country:_________________________________________________________________________
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E-Mail: ((Required)Please, spell and write
correctly with capital letters)
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________________________________________________________________________________
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Telephone:______________________________________________________________________
Fax:____________________________________________________________________________
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Card: American Express [__] Diners Club [__] Mastercard [__]
Visa [__]
Card Number: __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
Cardholder's Name:
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________________________________________________________________________________
Expiry Date: _____/_____ |
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CVV: __ __ __ __ (WHAT IS CVV? For Visa & MasterCard, the CVV is a
3-digit number printed on
the back of your card. For American Express, it is a 4-digit
number printed on the front of your card.) |
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Payment Policy |
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When
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Type
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Amount
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By
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At Reservation
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Credit Card Guarantee Only
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-
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Credit Card
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At Check Out
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Final Payment
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Balance
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Credit Card or Cash
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Signature:_______________________________________________________________
(Required)
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Accommodation ! Arrival Date ! Departure Date ! How many guests |
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!__________________!______________________!__________________!____________!
!__________________!_________________ ____ !__________ _______ !____________!
!__________________!______________________!__________________!_______ ____ !
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Special requests:
_________________________________________________________________ |
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geneva-switzerland-on-line.ch
Fax N°: +41 22 345 15
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