www.Rossellino.it

  CREDIT CARD AUTHORIZATION FORM
   * Fields marked with an asterisk are mandatory
     
* e-mail:  
     
* Name on Card:  
* Payment Methods:  
* Credit Card Number:  
* Expiration Date:  
* Cardholder Phone:  
     
* Signature of Card Holder: ______________________________________  
* Current Date:  
By submitting this form and any supporting documents, I confirm that I have read and agreed to the use of the personal information I am giving you in accordance with your Global Privacy Policy for Guests, which is available at www.rossellino.it/privacy.htm  
 
Please mail this completed form to:

 

Hotel e.mail #:

 
  each request is subject to confirmation of the hotel

Rossellino