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Reservation
Reservations
Best Western Vilnius
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Salutation
Name *
Surname *
p.
Dr.
Prof.
Name of enterprise
Address
City
Postcode
Country
Telephone *
Fax
E-mail *
Order
Date of arrival *
Departure date
Year
2010
2011
2012
/
Month
1
2
3
4
5
6
7
8
9
10
11
12
/
Day
1
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31
Year
2010
2011
2012
/
Month
1
2
3
4
5
6
7
8
9
10
11
12
/
Day
1
2
3
4
5
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21
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23
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25
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29
30
31
Number of rooms
Type of bed
One sigle bed
Two single beds
Double bed
Extra services
Additional bed
Non smoking room
Room type
Single room
Double room
Suit
Apartment
Mode of payment
(choose one)
Payment in advance, by bank transfer
Cash (deposit will be required upon arrival)
By credit card
Number of credit card
Validity till
Type of credit card
Number of credit card
Year
/
Month
VISA
EUROCARD
MASTERCARD
AMERICAN EXPRESS
DINERS CLUB
2007
2008
2009
2010
2011
1
2
3
4
5
6
7
8
9
10
11
12
This is a secure form, but if you do not wish to submit your credit card information by e-mail, you can also print out, fill in and fax this form to: +370 5 2739500
Transport
From the airport
Arrival time
hour . (00-23)
min . (00-59)
Flight number
Confirm
by fax
by phone
by e-mail
Notes
* mandatory fields
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