** Hotel Chaco **

By completing the following form you will be able to make your reservation ‘on line’.

*This reservation will become valid when you have received the Hotel’s confirmation.

PERSONAL DATA

Full name of the passenger: *

Company: *

Address:

E-Mail: *

Telephone:		Fax:
City:		Country:

Requested by:

RESERVATION DATA

Date of Arrival: *

(d/m/y)

Date of Departure: *

(d/m/y)

Via: *

	Airline	Flight Number:
	Bus	Company:
	Other

Type of Room: *

	Single	Number:
	Double	Number:
	Twin	Number:
	Triple	Number:
	Suite	Number:

Number of passengers: *

Notes: