FAX RESERVATION REQUEST FOEM
Please fill the following and send it by fax.
We will reply to you by fax within a few days
fax number(-81-829-44-0222)

Date of Arrival Day Year
Date of Departure Day Year


Your RequestService Only stay
With breakfast

 Number of adult
Number of Rooms require

Payment We do not accept credit cards.
Please make your payment by japanese currncy "yen".

Name;



ZIP code;
-
Address;
Telephone number;
- -
E-mail;

Space for message;

Miyajima Hotel new Kotobuki Corporation