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SECURE
RESERVATION FORM (SSL
128bit) |
| Cardholder's Name |
(Cardholder MUST be among travelling party) |
| Email |
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| Cardholder's Billing Address |
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| City |
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| State/Province |
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| Zip
Code |
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| Country |
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| Billing telephone number |
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| Secondary telephone number |
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| FAX |
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| Arrival
Date |
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| Departure
Date |
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| Total
# of Nights |
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| Number
of Guests |
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| Type
of Room |
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| Arrival
Time |
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| Special
Booking Code |
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| Payment
Method |
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| Credit
Card Number |
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| CCV # |
3 digit number on the back of the card |
| Expiration
Date |
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| Cardholder's name as it appears on card |
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| How
did you hear about us? |
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| If
"other", please specify: |
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| Comments: |
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I
have read, understand and agree to your rates, taxes, cancelation and refund policies,
as stated on your Rates page. (Type YES in the folowing field making sure
you have read, understood and agreed to them) |
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IMPORTANT NOTICE: TO ENSURE THAT YOU WILL RECEIVE OUR REPLY IN YOUR INBOX AND NOT IN THE SPAM FOLDER, ADD OUR EMAIL (palmplazaresort@aol.com) TO YOUR ADDRESS BOOK. Your software or ISP may accidentally filter our e-mail from your inbox. To prevent this, add our e-mail to your address book. For more information, please Click here!
YOU
SHOULD RECEIVE AN EMAIL CONFIRMATION WITHIN 24 HOURS. NO RESERVATION
IS CONSIDERED CONFIRMED UNTIL YOU HAVE RECEIVED AN EMAIL OR PHONE
CONFIRMATION. SO IF AFTER 24 HOURS YOU STILL HAVE NOT RECEIVED
A REPLY FROM US, PLEASE FOLLOW-UP WITH A CALL AT (954) 260-6568.
MAC
9 AOL users may receive a download "formmail.pl" in response,
instead of the "Mail sent confirmation". Not to worry. Your
form has been sent and you should receive a confirmation by email within
24 hours.
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Your
credit card information will be transmitted via a secure connection (SSL
128 bit) to our web server.
However, if you feel uncomfortable sending your
information over the internet, call us at 954-260-6568.
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