Pieve di Caminino Fax Reservation Form

Reservation Form via Fax:

PIEVE DI CAMININO HISTORIC RESORT
Hosts: Piero e Daniela Marrucchi Locatelli
Tenuta di Caminino - Strada Prov. 89
Roccatederighi (GR) 58036, Italy

Print it and fax to number: +39 0564 568756
Phone +39 0564 569736/7
e-mail: Pieve di Caminino

Client Information:
Name on Credit Card: ______________________________________________________
Address1:______________________________________________
Address2:______________________________________________
Apt# :_______
City:___________________________________
State:_____________
Zip:_________
Country:________________________
E-Mail: _____________________________________________________
Telephone (very important):___________________________________________
Fax: __________________________________________________

Card: [Visa __] [M/C __]
Card# __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
expiry date : ______/_____

3 digit pin code________

Signature:_________________________________________________
(Required for credit card orders)

Type of apartment | Arrival Date Departure Date | How many people

_________________|_____________________|_____________|___________
_________________|_____________________|_____________|___________
_________________|_____________________|_____________|___________
_________________|_____________________|_____________|___________

Special requests:
_____________________________________________________

_____________________________________________________