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Please fill out the following form

* Required fileds
Full name (first, last) *
Address *
City *
Zip
Country *
Phone *
Fax
E-mail *

Company

Company

Reservation info

Arrival Date and Time / / at
Departure Date and Time / / at
VIP
Number of people for
acommodation *

Number of room wanted *

Single(s) standart suite
Double standart suite

Payment method

Credit Card
Expiration date: / (yy/mm)
Number
Card Owner

Other payment method

(specify)
Additional comments
or request
How the Hotel should confirm this reservation or send the requested information Email
Phone
Fax

Our contacts:
tel./fax: (+38044) 278-5092, 278-5347

9, Tryokhsvyatytelska Str., Kyiv, 01001, Ukraine

E-mail: gintama@voliacable.com