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ITALY BY VESPA ORDER FORM 2015 SEASON 5 NIGHTS
Please complete this form and return:
By scan email: info@italybyvespa.com
By fax to: (720) 437-7063
By Mail: 8501 W. 8th Ave Lakewood C0 80215 USA
Today’s Date
Participant Name:
/
Spouse/Guest Name:
Mailing Address:
E-Mail Address: __________________
Phone: _____________________
How did you hear about us?
Normal Season
April 11 – May 9
June 6 – August 29
September 26 – October 24
Price
Peak Season
May 9 – June 6
August 29 – September 26
Extend
Standard Room 5 days / 5 nights
Standard Room 5 days / 5 nights
€2,180.00 (+ IVA tax)
€2,700.00 (+ IVA tax)
€ 2,681.40
One person including IVA
One person including IVA
*single supplement see below
Price
Extend
€ 3,321.00
*single supplement see below
€ 5,362.80
Two persons including IVA
Two persons including IVA
Upgrades / Single Supplement
€ 6,642.00
Upgrades / Single Supplement
€
€
€
€
Single Supplement
Deluxe Room Upgrade per couple
Deluxe Suite Upgrade per couple
Private Villa Upgrade 1 or 2 bdrm
210.00
435.00
890.00
890.00
Single Supplement
Deluxe Room Upgrade per couple
Deluxe Suite Upgrade per couple
Private Villa Upgrade 1 or 2 bdrm
Other
€
€
€
€
210.00
435.00
890.00
890.00
Other
Total Euros
Total Euros
Tour Date
Tour Date
Tours begin on Saturday’s
Tours begin on Saturday’s
Are you interested in trip cancellation
insurance YES / NO
Are you interested in trip cancellation
insurance YES / NO
Can be purchased within 14 days of deposit
Can be purchased within 14 days of
deposit
Deposit & Payment method (select one)
Non Refundable
( ) Non Refundable Deposit €1,000. Per Person
(Trip is CONFIRMED and balance is due in 60 days
If tour is within 60 days payment in full is required
and will be charged on that date to the card listed below)
€
(
) Bank Transfer (First Western Trust Bank of Colorado)
(Italy by Vespa LLC)
The ABA Number is: 102007011 Account Number: 2085501
Please fax this form to the fax number above
Non Refundable
( ) Payment in Full Non Refundable
€
(Trip is CONFIRMED or less than 60 days before departure)
(
) Check 10 days clearing required
Please forward check and this form to the address above
(
) Credit Card *conversion rate will include a 5% interbank charge
Read terms at left carefully!
Master Card / Visa (circle one)
note: AMERICAN EXPRESS is not accepted
Card Number:
Expiration:
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Last 3 digits on back of card: (
)
Name as it appears on Credit Card:
Credit Card Billing Address:
Zip Code
Client & Cardholders Signature X
Cardholder Acknowledges to pay amount stated above and agrees to the above terms and conditions contained heron and on www.italybyvespa.com
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