UAE ENTRY PERMIT SERVICE REQUEST FORM

							                       Tel# +971 4 3366000 Fax# +971 4 3104634
    E-mail: Muhammad.Hafeez@moevenpick.com/hotel.burdubai.reservation@moevenpick.com
                              RESERVATION REQUEST FORM
                                Accommodation for ESMRMB Participants

 Surname                                                   First Name
      ___________________________________                                 __________________________________

 Accommodation Type:
 Please indicate clearly whether Single or Double and strike off
  ( ) AED 650 for Superior Single
  ( ) AED 750 for Superior Double
       Per Room, Per Night

           Above rates subject to 10% Service Charge and 10% Municipality Tax
           Inclusive of Buffet Breakfast at the Fountain Restaurant

 Passport#                                                 Expiry date
                  ________________________________                        __________________________________
 Telephone #                                               Fax#
                                                           Email          __________________________________

 Arrival date                            Flight #                                  Arrival time
             _____________________                  ________________________               _____________________
 Departure date                          Flight#                                   Departure time
             _____________________                  ________________________               _____________________


                                                GUARANTEE
                                (Only Guaranteed Reservations will be accepted)

I hereby agree that Moevenpick Hotel Bur Dubai will charge the cost of the visa fee, Marhaba Service (if requested)
and one (1) night room charge to the credit card below in case of no-show or cancellation.

Guaranteed by: AMEX ( )                 MC (    )                VISA (   )              DINERS (    )

Credit Card# _______________________________             Expiry Date: ______________________________

Name of Cardholder __________________________            Signature ________________________________

Transit visa fee AED 500.00 YES ( )        NO ( ) (maximum of 4 full working days processing)
Marhaba Service AED 85.00 YES ( )           NO ( )
Limousine Airport Transfers per car per trip to Dubai International Airport AED 80.00 YES ( ) NO ( )


                                        PLEASE ACKNOWLEDGE BELOW
      Please enclose clear copy of the passport that indicates all above details
      SERVICE VISA (Transit Visa) is valid for a period of 14 days from the date of issue, and guest can stay
       14 days maximum from the date of entry to UAE.
     Service visa will not be processed unless guaranteed by valid credit card.
     Same fee will be charged if the Immigration Authority rejected the visa application.
     Original visa will be deposited only to Dubai International Airport.
     Arrival and departure should be in Dubai International Airport only.
     One room night will be charged to the credit card in case of no-show or 24 hrs cancellations.
      Issuance of the visa is solely at the discretion of the Immigration Authority.
    PLEASE RETURN THIS FORM TO Mr. Muhammad Hafeez
     FAX NO.00971 4 3104634        OR      E: MAIL: hotel.burdubai.reservation@moevenpick.com AND
                                                       Muhammad.Hafeez@moevenpick.com