Licenciado

Reservation and Deposit Form


1. What would you like to do?


□ Reserve at Spa/Lifestyle Executive Spa Suites (Puerto Plata, Dominican Republic)x
( Reserve atLifestyle Presidential Suites (Puerto Plata, Dominican Republic)
( Reserve at Lifestyle Hacienda Resort (Puerto Plata, Dominican Republic)
□ Reserve at a Sister Resort (pleasespecify): ____________________________


Your travel dates are from _05_/____April____/__12__ to __08__/____April____/__12__
Alternate travel dates ____/________/________/________/____


( Deposit with R.C.I. – please provide RCI Number: ________-____________


2. Identification


Is the member part of the reservation **: Yes ( No (Contract #: 7308


Surname (Member): _______Robert_________ Name(s): _____Monika________


Phone: ** _____809-769-1122_______ Fax: ___________________________E-mail: ** monikarobert07@hotmail.com_ Number of Travelers: **____1 adult_____


Traveler Name (Guest) **: _______________Jose Rafael Vargas Compres__________________(I.D. required at check-in)


How many weeks will you use? ______ _________Weeks/
LHVC ResortNights
( Studio ( 1 Bedroom ( 2 Bedroom ( Penthouse ( Villa X
US$199 US$ 259 US$ 299 US$499 US$ 899 _________ US$Presidential Suites
( Studio ( 1 Bedroom ( 2 Bedroom
US$299 US$ 499 US$ 699
Executive Spa Suites
( Studio
US$259Total cost of Service fees > ____85.26__ US$


3. Payment Information**

□ I wish to use my Bonus Certificate (no Credit Card Details required)
( I wish to use an...