My B&B in Rome
INFO/RESERVATION FORM

(Print, fill in by hand and fax at +39 06 3234397)


[ ] tick here if you require INFORMATION
[ ] tick here if you wish to make a RESERVATION

FULL NAME:
ADDRESS:
CITY:
COUNTRY:
TEL:
FAX:
E-MAIL(important):
OFFICE TEL:


PERIOD OF STAY IN ROME(required):
Total number of nights:
Total number of persons in your party:
Number of children:

tick the room(s) you request info for / you want to reserve (if any):

[ ]Ostiense Room (as double: $75/day) (as single: $60/day)
[ ]Arenula Room (as double: $120/day) (as single: $100/day)
[ ]Prati Room (as double: $110/day) (as single: $90/day)


QUESTIONS/COMMENTS:






















FILL THE FOLLOWING PART ONLY IF YOU ARE MAKING A RESERVATION:


NATIONALITY:
PLACE OF BIRTH:
DATE OF BIRTH:
PASSPORT NUMBER:
PASSPORT EXPIRATION DATE:


ROOM YOU WISH TO RESERVE:

TOTAL DUE FOR NUMBER OF DAYS SPECIFIED: $

DEPOSIT DUE: (30% of total due + $10 tax expenses): $




Signature:

We accept payments only through a BANK WIRE TRANSFER

N.B. As soon as we receive your reservation form, we will send you a CONFIRMATION E-MAIL. You will then have 3 BUSINESS DAYS to send us a fax containing a copy of the bank's receipt for the DEPOSIT you specified above. The reservation will be considered valid only after we receive your deposit receipt fax.



The content of this document will be kept strictly confidential and will not be shared with a third party as established by Italian Privacy Regulation