FORM
Please fill out the form below.

     
 
surname
  
 
first name
  
 
address
  
 
postal code
  
 
town
  
 
country
  
 
phone
  
 
fax
  
 
e-mail
  
 
special request
  
 
 
Rooms type
Low season
High season
US dollars US dollars
Single suite $55.00 $70.00
Double suite $65.00 $80.00
Single deluxe $60.00 $75.00
Double deluxe $70.00 $85.00
Breakfast
$8.00
 
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