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HOTEL RESTAURANT
La Villa
S.S. 147 Assisana, 124
06083 Bastia Umbra - Bastiola (Perugia) Italy
Tel. +39 0758010011 - 
 Fax +39 0758010574

 

Thank you for visiting our Home-Page. 
If you wish to book a room for your holiday or want further informations PRINT this form, FILL IT OUT (in block letters) and SEND IT via fax.

NAME _________________________________   SURNAME __________________________________

*Company ____________________________  Address ______________________________________

City ___________________  ZIP_________  State _____________  Country ___________________

Int. code _____ Ph. __________  Fax: _____________  E-mail ________________________

1) DATE OF ARRIVAL _____________  2) DATE OF DEPARTURE ____________________
ROOM TYPE:
SINGLE ROOM Bed & Breakfast   number  ______
DOUBLE ROOM Bed & Breakfast   number  ______
**Information Request ___________________________________________________

________________________________________________________________________
CREDIT CARD
VISA MASTERCARD DINERS AMEX
     
N. ___________________________________ EXP. _________(MM/YYYY)
CREDIT CARD HOLDER:

NAME ____________________ SURNAME ________________________