PERSONAL INFORMATION
NOTE: Please fill up those fields mark
with " * ".
Title :
Mr.
Mrs.
Miss
*
Firstname :
*
Lastname :
*
Email Address :
*
Email Address 2:
Second
E-mail address, if any
Tel/Mobile Number :
Please
advise Mobile Phone Number to receive Text Message from us incase
we are unable to reach you by emailor by phone.
FAX Number :
Correspondence Address
:
Country :
Nationality :
*
RESERVATION / BOOKING INFORMATION
:
Types of bed :
Please select one:
Single Room
Twin Room
Double Room
Triple Room
Deluxe Room
Junior Suite
Senior Suite
Pondichery
Number of Room Required :
1
2
3
4
5
6
7
8
9
10
more than 10
more than 20
more than 50
more than 100
Extra bed :
Number of person (adult)s :
Number of Children ( if any ) :
0
1
2
3
4
5
Age of Children :
Indicate here if more
than 1 type of rooms are required. Please also furnish names of
the guests for the additional rooms
Indicate
here for any special request ( extra bed, bed types preferred, connecting
room, etc.)
Date of Check In :
Date of Check Out :
Preferred payment method :
Please select one:
by Visa Card
by Master Card
by JCB Card
by Amex Card
Other ...
FLIGHT INFORMATION
Arrival Flight :
Flight name and no. ( Arrival ) :
Time of Arrival :
Departure Flight :
Flight Name and No. (Departure):
Time of Departure :
Please indicate if airport pick up
service is required :
From where you got to
know us :
Please select from the list :
Altavista.com
Yahoo.com
Google.com
Excite.com
HotBot.com
Infoseek.com
Lycos.com
AOL.com
nbci.com
msn.com
from other website