Name:
Email Address:
Nationality:
Telephone:
Cellular/Mobile:
Fax:
Credit Card Type:
Visa
MasterCard
Credit Card Number:
Expiration Date:
CCV (Credit Card Verification) Number:
Name On Card:
Comments:
Total Number of Nights (USD$32.70 per night):
2 Nights for USD$65.40
3 Nights for USD$98.10
4 Nights for USD$130.80
5 Nights for USD$163.50
6 Nights for USD$196.20
7 Nights for USD$218.00
8 Nights for USD$250.70
9 Nights for USD$283.40
10 Nights for USD$316.10
11 Nights for USD$348.80
12 Nights for USD$381.50
13 Nights for USD$414.20
14 Nights for USD$392.40
15 Nights for USD$425.10
16 Nights for USD$457.80
17 Nights for USD$490.50
18 Nights for USD$523.20
19 Nights for USD$555.90
20 Nights for USD$588.60
21 Nights for USD$610.40
22 Nights for USD$643.10
23 Nights for USD$675.80
24 Nights for USD$708.50
25 Nights for USD$741.20
26 Nights for USD$773.90
27 Nights for USD$806.60
Do You Allow Raul's Rooms To charge your Credit Card for The Sum displayed on the Reservation Form?
I agree
Do You agree to terms and conditions listed Below?
I Agree
create web form
Copyright © 2007 Acacia. All rights reserved.
Click Here
to view
Terms And Conditions
