RESERVATION FAX PALAZZO STARACE

To:    Palazzo Starace  +39.081.532.93.44

From:  _________________________________________________
                      name                                                     fax

Today's date:____/____/____             E-mail:_____________________
                   day   month  year

Please make this reservation for me:

Name:______________________

Total # of people: ____# of rooms:____#of nights:  ____

Arriving: ____/____/____ my time of arrival(24-hr): ___
                day    month  year    (I will telephone if I will be late)

Departing: ____/____/____
                  day    month  year

Room(s):    Single_____  Double_____Triple_____

( Palazzo Starace will charge the first night as a deposit)

Credit card:  Visa ___  Mastercard ___

Card#:_________________________________________________

Expiration Date: ______________________

Name on card:_________________________

Thank you.

________________________________________________________
Signature

________________________________________________________
Name

________________________________________________________
Address

________________________________________________________
City                                            State                Zip              Country