-----------------------Fax Form - www.perugiaonline.com-----------------------
HOTEL
CAMPIGLIONE
Hotel Campiglione di Ascani Cristina & Piero s.n.c.
Via Campiglione, 11
06083 - BASTIA UMBRA - Perugia - Italy
Phone (+39) 075.80.10.767

Fax (+39) 075.80.10.768
Thank you for visiting our home-page.
If you wish to book one or more of the following restaurant services 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_________

TYPE OF ROOM: SINGLE BED + BATH PERSONS :Q.ty________
DOUBLE BED + BATH PERSONS :Q.ty________
TRIPLE BED+ BATH PERSONS :Q.ty________

* REQUEST FOR PARTICULAR ROOM FEATURES YES NO
BREAKFAST N° PERSONS + ROOM TYPE_____________
SMOKERS N° PERSONS + ROOM TYPE_____________
CRIB N° PERSONS + ROOM TYPE_____________

* Information Request_____________________________________________
___________________________________________________________________ ___________________________________________________________________

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

Beneficiary : Hotel Campiglione di Ascani Cristina & Piero s.n.c. - P.IVA 01837750544
Amount of account payment : ITL 200.000 (twohundredthousanditalianlire)
Cause : Prenotazione camera - Hotel Campiglione
Beneficiary's Bank : Monte dei Paschi di Siena
Agency : BASTIA UMBRA - Piazza Mazzini
Cod. ABI 1030 CAB 38280 Account n° 7061.07


1) Room available from 12,00 o'clock     2) Leave the room within 10,00 o'clock     * Optional.
** Please send the receipt of the bank transfer along with the fax.