Casa Capuchinas Reservation Form

 

PERSONAL INFORMATION
Last Name First Name
Address Zip/City
Office-Phone Home-Phone
E-Mail Other

 

ROOM INFORMATION
Lodging from-to
  
Single Double Triple Whole House
Special Requirements?

 

FLIGHT INFORMATION
Airline Flight Number
Time of Arrival Arrival Date
Airport-Pickup? Yes No

 

PAYMENT INFORMATION
Credit Card Type Visa Master Card American Express Diners Club
Credit Card Number
Date of Expiration
Name on Card
Do you want to guarantee your reservation? Yes No

 

How did you find our about Casa Capuchinas B&B?
advertisement where?
Internet
others

 

 

For more information please contact:

CASA CAPUCHINAS B&B

information@casacapuchinas.com

Tel./Fax: +502-832-0121