Hotel Reservations Limited
                                                                               Molineux House      
                                                                               Russell Gardens      
                                                                            Wickford Essex SS11 8BL      
                                                                        Tel: - 01268 572003 Fax: - 01268 572002      
                                                                         E-mail res@hotelreservations.uk.com      
                                                Accommodation Request & Booking Form
       Destination or Post Code: -
       Event Attending (Optional): -
       Hotel Choice (If known)
       Hotel 2nd Choice (If known)
       Names / Name     (Capitals Please)
             Title                                                                                    Room Sleeps     Approx Arrival
          Mr/ Mrs/ Dr       First Name             Surname           Arrival Date    No of Nights     Type of Room         Time
       Payment Details
       All financial transactions and booking terms and conditions are direct with the hotel
       unless otherwise agreed with Hotel Reservations Limited
       Billing Address
            Name
          Company
          Address 1
          Address 2
          Address 3
            Town                                                  County
           Country                                                Post Code
            E-mail
          Telephone                                               Contact Fax
       Credit Card Holders Name
       Credit Card Type
       Credit Card Number
       Exp Date
       3 Number Code On reverse of card
       All Credit Card payment are taken direct from the Hotel on your departure 
       Details are required to confirm and guarantee your booking 
       Company Name (Optional)
       Please Invoice above Company Signature Required
       All bookings must be pre paid prior to arrival unless agreed
       For Office Use
    Res Number