ABURI KAISEKI FORM Name of reservation ___________________________ Date of reservation ____________________ Time of reservation____________ No. of Guests _________ Contact name __________________________Contact number ________________________ Contact email address ______________________________________________________________ Have you dined with us before? No Yes How many Females in your group? How many Males in your group? Have you had Miku’s Aburi Kaiseki before? No Yes If yes, when was your reservation and what name was it under? ______________________________ Special Occasion / for whom? ___________________________________________________________ ALLERGY INFORMATION NAME OF GUEST ALLERGIES PREFERENCES (Please separate guests’ allergies with a comma respectively to the above) Aburi Kaiseki orders require 72 hours notice. Please also allow at least 2 hours for dining. Due to the specialized nature, personalization and timing of the menu, we ask that all persons in the party participate in Aburi Kaiseki and one must be ordered per person. Office Use: Confirmation # _________________ A confirmation email and number will be sent to you within 24 hours once your request form is received. If you do not receive an email regarding your order, please contact our Guests Services on 604-568-3900 for assistance. Any changes to this order form or cancellation needs to be made in writing to the above email address to be processed. Please fill in your credit card information on the following page and once completed, please send both pages to info@mikurestaurant.com with the subject “ABURI KAISEKI” at your earliest convenience to ensure your request is processed before the cut-off date. Thank you and we look forward to having you at Miku. Credit Card Details^ Card Type Visa Mastercard American Express Credit card number ___________________________________________ Expiry date ________________ Signature of cardholder ______________________________________ Name of cardholder ______________________________________ ** Please Note: there will be an18% service charge added to the final bill ** CANCELLATION POLICY Any cancellations within the time frame provided below will incur a 40% cancellation fee per order. 1-4 party size 48hours notice 5-14 party size 7 days notice 15 guests and over Please ask management ^ The signature above authorizes Miku Restaurant to charge this fee against the above credit card should a cancellation of such nature occur. A front and back copy of the card plus photo identification for any pre payments as required by credit card companies for supporting documents to process any payment without the physical card. Office Use: Confirmation # _________________
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