This is a preliminary request form.
In case of confirmation, we will ask you to kindly fill up a complete and secure form.
PERSONAL INFORMATION
Last Name
First Name
*E-mail
Fax
ROOM
Arrival date
month
January
February
March
April
May
June
July
August
September
October
November
December
day
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
year
2010
2011
2012
2013
2014
2015
Total nights:
1
2
3
4
5
6
7
8
9
Type of room
Single
Double
Suite
Extra bed
1
2
Total rooms:
1
2
3
4
5
6
7
8
N° of adults:
0
1
2
3
4
5
6
7
8
N° of kids:
0
1
2
3
4
5
6
7
8
In the name:
Specification and other requests:
*required field
CASA BELMONTE
relais
• Via Belmonte, 2 • 36030 Sarcedo (Vicenza) Italy
Phone ++39-0445 884833 • fax ++39-0445 884134 • e-mail:
info@casabelmonte.com