FORM
Please fill out the form below.

     
 
surname
 
 
first name
 
 
address
 
 
postal code
 
 
town
 
 
country
 
 
phone
 
 
fax
 
 
e-mail
 
 
special request
 
 

 
TARIFFS 2000-2001
Rates in RD $
Rates in US $
Simple room 1 person
610.000
37.60
Simple room 2 people
750.000
46.20
Simple room 3 people
830.000
51.10
Suite 1 person
725.000
44.70
Suite 2 people
850.000
52.40
Suite 3 people
725.000
44.70
Balcony (optional)
40.00
Continental breakfast
70.00 p.p
American breakfast
80.00 p.p

Prices are with all inclusive tax
 
ARRIVAL DATE
   
 
N° nights  
 
 
N° rooms  
 
 
N° of persons
 
 
Type of room
 
 


METHOD OF PAYMENT

 
 
1)20% of the total cost at the reservation by:
Cheque Credit card  
 
2) Balance:80% at the hotel after your arrival:

Cash Credit card

 
 


If payment (20%) by cheque please send it at the order of :

DOMIEXEL Sarl

57 Av du Général DE GAULLE
97190 GOSIER
GUADELOUPE

 

As soon as we'll receive your cheque your reservation will be confirmed

 
 

 
 
SECURED PAYMENT BY CREDIT CARD
 
 
Choose your credit card
 
 
Card number
 
 
Date validity
 
       
 

Total reservation

 
 
I AUTHORIZE YOU TO DEBIT MY CREDIT CARD
FOR THE AMOUNT OF :
 
 
 
 

CORRESPONDING TO  20% of the total of the reservation

THIS DEBIT WILL BE DONE AFTER OUR CONFIRMATION