-----------------------Fax Form - www.perugiaonline.com-----------------------

ALBERGO
IL PALAZZO
Management:
Hotel "Il Palazzo" di Orietta Lupi
Via San Francesco, 8
06081 - ASSISI
Perugia - Italy
Phone(+39) 075.816.841
Fax (+39) 075.812.370

Thank you for visiting our Home-Page.
If you wish to book a room for your holiday or want further informations PRINT this form, FILL IT OUT (in block letters) and SEND IT via fax.

Name___________________________ Surname___________________________

*Company________________________ Address______________________________

City/Town_____________________ Postal Code______ Country____________

International Dialling Code____ Phone_________ Fax_________ E-mail_________

1)DATE OF ARRIVAL_______________ 2)DATE OF DEPARTURE________________

TYPE OF ROOM
 SINGLE + WC  Night stay +     breakfast  Half board  Full Board PERSONS n°___
 DOUBLE + WC  Night stay +     breakfast  Half board  Full Board PERSONS n°___
 TRIPLE + WC  Night stay +     breakfast  Half board  Full Board PERSONS n°___
*REQUEST FOR PARTICULAR ROOM FEATURES  Ž SI         Ž NO
     SMOKERS N° of persons + room type______________
     HANDICAPPED PERSON N° of persons + room type______________
     CRIB N° of persons + room type______________

*Information Request_____________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

**IMPORTANT!! To be sure of the availability of the chosen room in the period indicated, please send a PAYMENT ON ACCOUNT through Credit Card (in Euro)

CREDIT CARD
VISA MASTERCARD DINERS AMEX
     
N. ___________________________________ EXP. _________(MM/YYYY)
CREDIT CARD HOLDER:

NAME ____________________ SURNAME ________________________


1) Room available from 12,00 o’clock 2) Leave the room within 10,00 o’clock * Optional. ** Please send the receipt of the bank transfer along with the fax.