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ROOM RESERVATION FORM and AUTHORIZATION LETTER - isodel

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ROOM RESERVATION FORM and AUTHORIZATION LETTER - isodel Powered By Docstoc
					                    ROOM RESERVATION FORM and AUTHORIZATION LETTER
                            ISODEL 2012 Bali 4th – 6th DEC 2012


Please complete the following form and send back to ADHI JAYA Hotel                      via email :
sales@adhijayahotel.com    ,   indra_adhijaya@yahoo.com,        cc:   accommodation@isodel.org      ,
intansenduk@pt-mts.com or facsimile to +62 361 763445 to attention Adhi Jaya Hotel, +62 21 7401727 to
attention ISODEL 2012

Name                            :1.____________________________
                                 2.____________________________
                                 3.____________________________
Check in date                   : ……………………………………………………………………
Check out date                  : ……………………………………………………………………
Room type                       : Superior Room at Rp.800.000,-net/room/night include breakfast
                                  for max 2 persons (Confirmation are subject to room availability)
Total Room                      : ……………………………………………………………………
Total pax                       : ………………………Adult/room
Total Payment                   : ……………………………………………………………………

PERSONAL DETAILS
Telephone                       : ……………………………………………………………………
Arrival time                    : ……………………………………………………………………

CREDIT CARD INFORMATION:
I Authorized ADHI JAYA Hotel to charge payment of our room reservation above to my credit card as
follows :

CARD TYPE                       : ……………………………………………………………………
Cardholder’s name               : ……………………………………………………………………
Credit card no                  : ……………………………………………………………………
Expiry date                     : ………… /………… (month/year) Card ID …………*
Amount debit                    : ………………………USD/IDR

Cardholder Signature            : _________________________Date: ____________________

*Card ID for VISA or master card is the last three digits number as signature panel on the back side Card.
*Card ID for American Express cards is a four-digit number printed on the front of the card, above the
 account number.
** Please kindly attached a copy of the front and back of the credit card and passport or ID card
The credit card details is only for guarantee booking and the payment should be paid directly to the hotel
upon arrival and payment in USD we will convert to IDR (based on hotel currency exchange rate).

Cancellation policy:
-14 days upon arrival will be charged a one night cancellation fee per room
- No show, will incur full period charge

Authorized Signature            : __________________________________

Date                            : __________________________________


                                     Kartika Plaza St, Kuta Bali- Indonesia
                                 Phone: (62-361) 756 884 Fax: (62-361) 763 445
                       Email: info@adhijayahotel.com Website: www.adhijayahotel.com

				
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