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INDIVIDUAL FORM
Type of Room:
Single 1 bed
Double 2 beds
Double Family Plan
Triple 2 Double beds
Quadruple_2_double_beds
PASSENGER INFORMATION
PAX NAME(S). names of all persons sharing the room
1. Last Name:
First Name:
Adult
Child:/age:
2. Last Name:
First Name:
Adult
Child:/age:
3. Last Name:
First Name:
Adult
Child:/age:
4. Last Name:
First Name:
Adult
Child:/age:
HOTEL INFORMATION
Hotel Name:
City /State:
Dates:
Check In:
Jan
Feb
Mar
Apr
May
Jun
Jul
Ago
Sep
Oct
Nov
Dic
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
2009
2010
2011
2012
Check Out:
Jan
Feb
Mar
Apr
May
Jun
Jul
Ago
Sep
Oct
Nov
Dic
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
2009
2010
2011
2012
AGENCY INFORMATION
Agency name:
Agent name:
Email Agency:
Request Date :
Jan
Feb
Mar
Apr
May
Jun
Jul
Ago
Sep
Oct
Nov
Dic
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
2009
2010
2011
2012
Special Request:
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Tel: 786-207-2733
Fax: 786-207-8217
Toll Free: 1877-396-8057
info@fourwindsusa.com
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