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

HOTEL PANDA
Hotel Panda s.a.s.
Via Giuseppe di Vittorio, 5
06088 - ASSISI
Perugia - Italy
Tel. (+39) 075.80.43.680
Fax (+39) 075.80.43.680

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° __

* REQUEST FOR PARTICULAR ROOM FEATURES YES NO

SMOKERS N° OF PERSONS + ROOM TYPE_____________
HANDICAPPED PERSON N° OF PERSONS + ROOM TYPE_____________
CRIB N° OF PERSONS + ROOM TYPE_____________

* Information Request _____________________________________________________
_____________________________________________________________________________

_____________________________________________________________________________


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

NAME ____________________ SURNAME ________________________


1) Room available from 14,00 o’clock 2) Leave the room within 10,00 o’clock * Optional. ** Please send the receipt of the bank transfer along with the fax.