Reservations Form - Galla Manor Guest House - Nelspruit, Mpumalanga, South Africa

Reservation Form.

Galla Manor - One of our luxurious suites Galla Manor - Garden View Galla Manor - Bedroom Suite

Should you wish to make use of an alternative payment method such as EFT (electronic funds transfer) or prefer not to submit your credit card information via this site, please download our booking sheet, complete it and return it to us by fax to +27(0)13 744 1482. Adobe Acrobat Reader is required to read and print this form.

Fields that are highlighted are required fields.

Personal Information

Title:
Reservation for Name:
Number of Adults:
Number of Children (under the age of 10):
Telephone Number:
Facsimile Number:
Mobile Number:
E-mail Address:
Prefered method of communication:
Check-in Date:
Departure Date:
Special Requirements:

Payment Details

I, hereby authorize Galla Manor Guest House to debit my credit card...

Credit Card Type:
Card Holders name:
ID / Passport Number:
Credit Card Number:	Do not use spaces.
CVV Number:	Last 3 digits on reverse of your card.
Expiry Date:	MM YYYY
Please re-type the number shown:

with 50% of the full amount payable as a deposit to secure my reservation.
Please note!! NO deposit will be taken until the reservation has been confirmed.