| Person To Contact |
|
| E-mail Address |
|
| |
Please ensure to include your accurate e-mail address (user@system);
otherwise HSA would reply |
| Home telephone No. |
Include Country's Dialling
Code |
| Day/Work Telephone number |
Include Country's
Dialling Code |
| How Did You Hear Of Us |
From: |
| |
|
|
The Accommodations To Be
Confirmed |
| |
|
| Self Catering |
Other Type: |
| Hotel Rooms |
Other Type: |
| Arrival |
|
| Departure |
|
| Type Of Accommodation |
|
| Total No. Of Adults |
Total Children under 12 years:
|
| Ages of Children Under 12 years |
|
| Name of Hotel/Apartment |
|
| Destination Resort |
|
| Destination Country |
|
| Destination City |
|
| Destination Flight No. |
|
| Destination Estimated Time of Arrival |
|
| Destination Airport |
|
| Currency |
|
| Total Price |
Enter the total amount as per our
offer |
| 4% Surplus for Credit Card |
|
| Total |
|
| |
SUBJECT TO AVAILABILITY
The
accommodation was available at the time the offer was made.
On receipt of
the confirmation payment form, the 1st stage,
provided the credit card holder has completed the secure credit card
details, 2nd and 3rd stage, Holiday Serviced Apartments will re-check
availability of the accommodation offered and if it is still available, the
credit card will be processed and charged. If the accommodation is no longer
available, no charge to the credit card will be made and the offer will be
cancelled
THE CHARGES FOR THE ACCOMMODATION AS PER OFFER
(To be completed in
full As Per HSA Offer)
|
| |
|
| Accommodation Offered |
|
| Accommodation to be confirmed in the name of |
|
| Card Holder's Nationality |
|
| Card Holder's Passport No. |
|
| |
I agree to the terms and conditions |
| |
|
