Coast of Amalfi - request form

PERSONAL DATA
The personal data indicated in this form will be treated
as strictly confidential and will not be given to any
organization, company, board or other for any reason.

Full name
Address
City
State
Zip code
Country
Phone
Fax
E-mail
Arrival Date
Departure Date
Number of people
Number of nights

Apartment type (Please indicate the number of rooms you need to book)
Double rooms in hotel
Single rooms in hotel
Remarks: Please specify any special service/necessity request.
Please consider this form as a request of availability to be followed up by our confirmation.

How did You find us ?

	do not know, do not remember
	with a search engine
	a friend suggested me
	following a link from another site
	reading a magazine
	other...

If You have found us by a search engine, please, specify which one: