HOTEL RESERVATION FORM

INSTRUCTIONS: Please carefully read the Terms and Conditions accompanying this page. Complete all sections, sign and date form below and return immediately via fax or mail. This form is required no later than final payment date. Hotel reservation is not complete without returning this completed and signed form to Palace travel. Please PRINT in black ink. Make additional copies as needed.

HOTEL(S): ________________________________________________________

_______________________________________________________________________

DATES:_________________________________________________________________

ROOM TYPE REQUESTED (Please check box): ( ) Double ( ) Twin ( ) Single ( ) Suite

Number of Guest(s) per room: ____________________________________________

Please note: Double room implies room with 2 guests sharing a double, queen or king bed, as available at time of check in. We cannot guarantee any specific bed type in advance. Twin room implies room with 2 twin beds.

Please reserve _____ Room(s) at the __________________________ (Name of Hotel )

Enclosed is my check of $ ___________________ for ____________________ rooms.

Please make check payable to: PALACE TRAVEL, INC. and return this completed form to 5301 Chestnut Street, Philadelphia, PA 19139 USA.

Please charge my deposit of $ _______________ to ( ) AMEX ( ) Visa ( ) Master Card

Credit Card Number: _____________________________________________________________
(Attach copy of front and back of credit card)

GUEST (1)

(1) NAME: (AS IT APPEARS IN PASSPORT) ______________________________________________

SEX: ( ) MALE ( ) FEMALE

SMOKER: ( ) YES ( ) NO

STREET ADDRESS: ________________________________________________

CITY, STATE, ZIP: _________________________________________________

TELEPHONE (WORK):_____________________

(HOME): _____________________ (CELL): ____________________

E-MAIL: __________________________________

GUEST (2) (If Paying Separately)

NAME: (AS IT APPEARS IN PASSPORT) ______________________________________________

SEX: ( ) MALE ( ) FEMALE

SMOKER: ( ) YES ( ) NO

STREET ADDRESS: _______________________________________________

CITY, STATE, ZIP: _______________________________________________

TELEPHONE (WORK): __________________

(HOME): ________________________ (CELL): ___________________

E-MAIL ADDRESS:___________________________

OTHER GUESTS: _______________________________________________________

________________________________________________________________________

_________________________________________________________________________

IN CASE OF EMERGENCY, PLEASE CONTACT:_____________________________

RELATIONSHIP: ________________

TELEPHONE (DAY): _________________ (EVEN): ________________

FINAL PAYMENT DUE 15 DAYS BEFORE CHECK-IN EXCEPT FOR GROUP RESERVATIONS OF 10 OR MORE ROOMS.

Signatures required of above passengers. I agree to abide by the PALACE TRAVEL’s Terms and Conditions accompanying this form, and will be bound by these Terms and Conditions. If passenger is under the age of 18, parental signature is required.

GUEST (1)

SIGNATURE: __________________________ DATE: _______________

GUEST (2)

SIGNATURE: __________________________ DATE: _______________

Reservation form must be completed, signed and received by Palace Travel no later than final payment date. Palace Travel will not be responsible for any consequences due to errors as a result of misspelled names on these lists. Any action or inaction taken by an airline or other transportation company is the sole responsibility of the guest.

A signed reservation form is an acceptance of the hotel reservation, rate confirmed, and constitutes acceptance of the Terms & Conditions.

Please print the reservation form and send it to us via fax or postal mail:

Fax:

(215)471-8898

Mail:

Palace Travel
5301 Chestnut Street
Philadelphia, PA 19139
USA.

Need help or have questions? Call us:

1-800-683-7131 or 1-215-471-8555 E-mail: info@palacetravel.com