First Name:		Last Name:
Address:
City:		Country:
E mail:
Home Phone :		Office Phone :
Arrival Date :		Departure Date :
Type of Room	2 Bed without kitchen (2 persons max) $70/ Night 1 Bed with kitchen (2 persons max) $80/ Night 3 Bed with kitchen & Family Suite (2 persons max) $85/ Night		Extra person $10/ Night,
.	1 2 3 4 5 Total No. of Person :	.
Credit Card Information
Name of Card :	Select Visa Mastercard
Card No. :		Exp. Date :
Any extra Note if you want to give:

All rooms are clean and the complete facility has been renovated in year 2009 .
All beds are changed in year 2010.
24 Hr Fax and Photocopy facility Available.
24 Hr Greyhound Bus Service from the front of the Motel.

Local and longdistance calls free (Long distance facility available from the office)
Barbeque facility available