Please provide the following information:

Name

The name on your credit card

Name

The billing address

Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
E-mail

Accommodation Name: 
Estimated Time of Arrival at Hotel: :
                                    Card Type : Visa Mastercard AMEX Other
                               Card Number :
                                  Expiry Date :
Last three numbers on signature side of card 
Total Amount authorised in Euro:
Same amount in Words:
                                                  Deposit :
Balance to be charged 30 days before arrival :

I hereby authorise you to debit my account for the amount stated in this form for the requested accommodation.

I have read, understand and accept the terms and conditions.

This space is for any comments or instructions you may have.

 

By pressing "Submit" below you are authorising Cyprus-Hotels.com to book your requested accommodation and for Cyprus-Hotels.com or its is reservation office to charge your credit card for the requested reservation. You are also accepting our terms and conditions.

Thank you. Confirmation will be sent to you shortly.