RESERVATION REQUEST FORM
Please fill the following and send it by e-mail. We will reply to you by e-mail within a few days
Date of Arrival Day Year Date of Departure Day Year
Your RequestService with breakfast included Only stay
Number of adult Number of children Number of Rooms require Number of stay Payment; We do not accept credit cards. Please make your payment by japanese currncy "yen".
Name; ;
Postal(Zip)Code ;	-
address(Apt/Home/Street) ; City/State ; Country ;
Telephone number;	- -
E-mail;
Space for a message :
Miyajima Hotel new Kotobuki Corporation