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 )

Palace Travel, Inc. ~ 5301 Chestnut Street -Philadelphia, PA. 19139
Toll Free: (800).683.7731 Office: (215) 471.8555 Fax: (215) 471.8898
(w) www.palacetravel.com ~ (e) info@palacetravel.com

GUEST (1)

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

STREET ADDRESS: ____________________________________________

CITY, STATE, ZIP: ____________________________________________

TELEPHONE (WORK):_____________________

(HOME): _____________________ (CELL): ____________________

E-MAIL: __________________________________

GUEST (2) (If Paying Separately)

NAME: (AS IT APPEARS IN PASSPORT) ______________________________

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: _______________

Palace Travel, Inc. ~ 5301 Chestnut Street -Philadelphia, PA. 19139
Toll Free: (800).683.7731 Office: (215) 471.8555 Fax: (215) 471.8898
(w) www.palacetravel.com ~ (e) info@palacetravel.com

Method of Payment:   Check    Credit Card    Wire Transfer (Contact us for bank details)

AMOUNT $ ______________

IF PAYING BY CREDIT CARD PLEASE PROVIDE THE FOLLOWING INFORMATION
Attach photocopies of the front and back of the credit card and of the card holder's Government issued identification. A 4% handling fee applies to each credit card payment.

CHECK CARDS & DEBIT CARDS NOT ACCEPTED

CREDIT CARD AUTHORIZATION:

CARD HOLDER'S NAME:  _____________________________

BILLING ADDRESS:  ________________________________

City_____________________ State_______ Zip__________

CARD TYPE:  __________________

CREDIT CARD #:  ______________________

EXPIRATION DATE:  ________________________

CVV #: _____________
THE CVV IS THE LAST 3 DIGITS ON THE BACK OF A MASTERCARD, VISA, AND DISCOVER CARD OR THE UPPER 4 DIGITS ON THE FRONT OF AN AMERICAN EXPRESS                                             

AMOUNT DUE: ______________

4% HANDLING FEE: __________ 

TOTAL: ____________________ 

I, the undersigned (print name) ____________________________authorize PALACE TRAVEL, INC to charge my credit card as follows for my and/or my companion's scheduled trip. 

SIGNATURE: ____________________________________

Palace Travel, Inc. ~ 5301 Chestnut Street -Philadelphia, PA. 19139
Toll Free: (800).683.7731 Office: (215) 471.8555 Fax: (215) 471.8898
(w) www.palacetravel.com ~ (e) info@palacetravel.com

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

Palace Travel, Inc. ~ 5301 Chestnut Street -Philadelphia, PA. 19139
Toll Free: (800).683.7731 Office: (215) 471.8555 Fax: (215) 471.8898
(w) www.palacetravel.com ~ (e) info@palacetravel.com