Family name

X

First name

X

Company

Adress

X

City

X

Zip Code

X

Telephone number

Fax

e-Mail

X

We will contact you at this e-Mail address.

Arrival date

X

month January February March April May June July August September October November December

day

0 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

Year

2009 2010 2011 2012 2013

Departure date

X

month January February March April May June July August September October November December

day

0 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

Year

2009 2010 2011 2012 2013

Number of nights

X

Room category

X

Single room Double room Triple room

Number of rooms

X

Number of adults

X

Number of children

Children’s ages

Remarks

X must be filled in