RIVIERA BEACH BUNGALOWS  

Girne, North Cyprus (via Mersin 10 – TURKEY), Tel: 00 90 392 822 2026 / Fax: 00 90 392 822 20 62

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 ORDER FORM

NAME / SURNAME: ………………………………………………………………………

ADDRESS:   ……………………………………………………………………………….

                         ……………………………………………………………………………

POST CODE: …………………....   CITY: …………………………………...

COUNTRY: …………………........

TEL.:………………………………   FAX: ……………………………………

Amount:  …………....... YTL

Credit card charges are made in Yeni Turkish Lira (YTL) at current exchange rates. (If you investigate your credit card statement, there may be some small                             differences due to the fluctuating exchange rates).

For the payment of my order, charge my credit card account given below:

Credit Card Number:   _ _ _ _  /  _ _ _ _  /  _ _ _ _  /  _ _ _ _

      VISA                        MASTERCARD             Expiry Date _ _ / _ _ 

I hereby authorize you to debit the above mentioned amount from my VISA / MASTERCARD and credit it to your Account No. 010-600189                        With Limasol Tόrk Kooperatif Bankasύ Ltd., Girne (Kyrenia) Branch.

The hotel cancellation should be made at least two months before the arrival date; otherwise, I accept the hotel fee and administrative                                costs to be charged into my credit card, and I appoint Limasol Tόrk Kooperatif Bankasύ Ltd. to do it.

Date: ……………………… ............................................            Signature: ……………………………………………….................................

The above payment is for one studio / galleried bungalow / superior room to be reserved from …../…../2006 to …../…../2006 for …… persons on                 B&B / HB basis.

The total amount stated above is the equivalent amount of GBP ……… according to today’s exchange rates. Exchange rates can be seen from the     following link: http://www.kktcmb.trnc.net/kur2006/kur240206.htm

This copy letter can be faxed on condition that it is signed by the Card Holder. As attached, please fax the photocopy of your                credit card (both sides), as well.