-----------------------Fax Form - www.perugiaonline.com-----------------------

Agriturismo - Casa Vacanze
BELVEDERE DEL FRANTOIO 		"La Selva del Frantoio Pucci" di Pucci Dott. Goffredo
Strada per il Puglia, 44 - Località Casalalta
06050 - COLLAZZONE
Perugia - Italy
Tel. (+39) 075.87.07.128
Fax (+39) 075.87.07.128
Thank you for visiting our home-page.
If you wish to to book a mini-apartment for your holiday or want further informations PRINT this form, FILL IT OUT (in block letters) and SEND IT via fax.

Name___________________________ Surname______________________________

*Company________________________ Address______________________________

City/Town_____________________ Postal Code______ Country_______________

International Dialling Code_______ Phone____________ Fax:_________________

E-mail________________________

1) DATE OF ARRIVAL_______________ 2) DATE OF DEPARTURE________________

MINI-APARTMENT TYPE " AGRITOURISM " :

ONE-ROOM   Q.ty N°___
( Max 2 persons )
TWO-ROOM   Q.ty N°___
( Max 2+2 persons )
THREE-ROOM   Q.ty N°___
( Max 4+2 persons )

MINI-APARTMENT TYPE " HOLIDAY HOUSE " :

ONE-ROOM   Q.ty N°___
( Max 2+1 persons )
TWO-ROOM   Q.ty N°___
( Max 2+2 persons )
THREE-ROOM   Q.ty N°___
( Max 6+4 persons )

*Information Request _______________________________________________

___________________________________________________________________

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**IMPORTANT!! To be sure of the availability of the chosen mini-apartment in the period indicated, please send a PAYMENT ON ACCOUNT through bank transfer (in Italian Lire) in favour of the following beneficiary:

Beneficiary: Dott. Pucci Goffredo - P.IVA 01652550540
Amount of account payment : Send 30% of total amount
Causale: Prenotazione miniappartamento - Agriturismo
( if your choice should be Holiday House, please indicate “Casa Vacanza” instead of “Agriturismo”)
Beneficiary’s Bank : Banca Popolare di ANCONA
Agency: di TODI 3 - PANTALLA
Cod. IBAN IT37N0530838701000000038295

1) Mini-apartments available from 12,00 o’clock 2) Liberare il miniappartamento entro le ore 10,00
* Optional.
** Please send the receipt of the bank transfer along with the fax.