Reservation Form via E-Mail or Fax -- Central Queenstown Condominium

CENTRAL QUEENSTOWN CONDOMINIUM

Reservation Form via Fax or E-Mail

Please make all your selections and enter all necessary information
before clicking the TRANSMIT button at the bottom.
Alternatively, you may fill out the form, then print and fax to +64 3 442 7043.
After each typed entry, press the TAB key
or else use the cursor to go to the next entry area.

I would like to:
Request further information
Make a reservation request

Salutation (Dr, Mr, Mrs, Ms)

Surname

First Name

Postal Address

Town & State/Province

Country

Postal Code

IMPORTANT -- PLEASE INCLUDE ALL CONTACT DETAILS BELOW

Telephone (home)

Telephone (business)

Fax

E-Mail Address (REQUIRED)

I am interested in staying during the following time period:

Date of arrival:

Date of departure:

Number of Adults Number of Children

Any other comments, questions or special requirements?

CREDIT CARD DETAILS (may be supplied now or upon confirmation of availability)
Please tick one of the following:
I will provide Credit Card details NOW (using SECURE SERVER)
OR
I will provide Credit Card details LATER (upon confirmation of availability or by phone/fax)

Please click one of the buttons, or else you may
print now and fax to +64 3 442 7043 .

I would like to:	Request further information Make a reservation request
Salutation (Dr, Mr, Mrs, Ms)
Surname
First Name
Postal Address

Town & State/Province
Country
Postal Code
IMPORTANT -- PLEASE INCLUDE ALL CONTACT DETAILS BELOW
Telephone (home)
Telephone (business)
Fax
E-Mail Address (REQUIRED)

I am interested in staying during the following time period:
Date of arrival:
Date of departure: