Citibank Great Hotel Packages
Reservation Form
PERSONAL INFORMATION
IMPORTANT!! Pls make sure that it is the name shown on your passport . (*) is a compulsory field.

1st Passenger

Title Name : First Name : Family Name :
Passport Nos *
2nd Passenger
Title Name : First Name : Family Name :
Passport Nos *
IMPORTANT!! Pls furnish complete e-mail address so that our reply could reach you
E-mail Address :
* (Correspondence E-mail address)
E-mail Address : (Second E-mail address, if any )
Fax No:
Telephone No : *
Company Name (if applicable) :
Correspondence Address :
Country :
Nationality : *
RESERVATION DETAILS
1st choice of Hotel :
2nd choice of Hotel :
Types of Rooms Required :
Number of Rooms Required :
Total Number of Adult :
Special Request :
Date of Check-in (dd/mm/yyyy)
Date of Check-out (dd/mm/yyyy)
Credit Card Details
* Please provide full credit card details in order to have priority in booking process cardholder must be one of the travelling party.and
Credit Card Holder Name :
*
Credit Card Type:
*
Credit Card Number :
*
Credit Card Expiry Date :
(month/year, example 12/09) *
Credit Card Issuing Bank :
Citibank
Credit Card Issuing Country :
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