Reservation Request  form

  Surname:   Mr Mrs Miss Ms

 First Name:

 Street Address:                           

City:Country Afghanistan Anguilla Antigua Asia Barbados Bermuda Canada Caribbean Island China Cuba Europe Guyana Grenada India Jamaica Japan St Lucia Mexico St Vincent Trinidad - Tobago United Kingdom Venezuela United States

Tel (Home)  

Tel (work):

Fax #  

E-mail address

Room Type                     Number of   Persons       

  Standard Room Superior Standard Business Suite Executive Suite        one two three Four five plus

Arrival Date   January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020

Departure  Date   January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020

Method of Payment Visa Mastercard American Express Cash Bank Transfer City Ledger Travellers Cheque

Name of Company:

Address of Company

Contact Name

Tel/Fax/ e-mail)

To confirm your reservation, we require one night's non refundable deposit.  You would need to fax your credit card number, expiry date and written authorization permitting us to charge your credit card with the amount confirmed from this request.

Additional facilities requested:

1 2 3 4 Number of beds required         Yes No Fridge $10usd/day   Yes No   Crib

Other

  Copy and paste this form to  admin@royalpalm.co.tt