I


RESERVATION

GUEST INFORMATION
Last Name

First Name

Phone Number
Fax Number

E-mail
 Passport

Address

City

State

Country

 

COMPANY INFORMATION
(Only if on company business)
Company
Title

Phone Number

Fax Number

E-mail
 Address

City

State

Country
RUC (Only Perú)

 

TIME OF ARRIVAL
DAY FLIGHT
MONTH AIRLINE
YEAR TIME
Hour
Min.

 

DEPARTURE DAY
(Check Out at 13:00h)
DAY
MONTH
YEAR

 

ACOMMODATION
APART / SUITES Category
 		Extra
Bed
Number of guests
DOUBLE OCCUPATION Category
 		Extra
Bed
Number of guests
SINGLE OCCUPATION Number of guests

 

FORM OF PAYMENT
If you wish to wire a transfer , please indicate below in "Special Requirements"
Credit Card Type
 		Holder's Name
Valid Thru
Month
Year
Card Number

 

SPECIAL REQUIREMENTS
 

 

Where do you want to receive your booking confirmation?

 

 




Calle Alvarez Calderón 194 esq. Miguel Dasso
San Isidro - Lima 27 Perú
Telfs.: (511) 4180000 - Fax: (511) 440-1939

Get in touch

informes@hotelroosevelt.com