Name of Card Holder To Contact (Required) *
E-mail Address (Required) *
Please ensure to include your accurate e-mail address (user@system);
otherwise HSA would reply
Home telephone No. (Optional)
Include Country's Dialling
Code
Day/Work Telephone number (Required) *
Include Country's
Dialling Code
Mobile Phone/Cell number (Optional)
Include Country's
Dialling Code
Country/city of of card holder
The Accommodations To Be
Confirmed
Self Catering
(unspecified) Studio
1 Bedroom 2
Bedrooms 3 Bedrooms 4
Bedrooms 5 Bedrooms Other (please
specify) Other Type:
Hotel Rooms
(unspecified) Double for single use Double Single Tripple Quad Other
(please specify) Other Type:
Check in date (Required) *
Day
1 2 3
4 5 6
7 8 9
10 11 12 13 14
15 16 17 18 19
20 21 22 23 24
25 26 27 28 29
30 31
Month January February March April May June July August September October
November December
Year
2011 2012 2013
Check out date (Required) *
Day
1 2 3
4 5 6
7 8 9
10 11 12 13 14
15 16 17 18 19
20 21 22 23 24
25 26 27 28 29
30 31
Month January February March April May June July August September October
November December
Year
2011 2012 2013
Type Of Accommodation (Required) *
Type
Aparthotel Hotel Apartment
Villa Motel Condominium
Total No. Of Adults (Required) *
1
2 3 4 5
6 7 8 9
10 11 12 13
14 15 Total Children under 12 years:
0
1 2 3 4
5 6 7 8
9 10 11
Ages of Children Under 12 years
Accommodation To Be Confirmed
Name of Hotel/Aparthotel/Apartment (Required) *
Destination Country (Required) *
Destination City / Resort (Required) *
Destination Flight No.
Required at a later time if not available
Destination Estimated Time of Arrival
Required
at a later time if not available
Destination Airport / Port of Embarkation
Required at a later time if not available
Enter the total amount as per our
offer including 4% credit card charge if applicable
Total Price (Required) *
Currency
Choose Currancy
GB Pounds
Euros
US Dollars
SUBJECT TO AVAILABILITY
The accommodation
was available at the time the offer was made. On receipt your instruction to
proceed form , provided the accommodation is still
available, we will call you during working hours
London Time 9.30 am to 5.00 pm (We close UK bank holidays, Christian and
Jewish festivities)
ALTERNATIVELY
You can call us during working hours to provide us with your credit card details
Once the credit card payment is processed , you will receive an immediate
confirmation from our
Merchant Bank to confirm payment has gone through or otherwise
THE CHARGES FOR THE ACCOMMODATION AS PER OFFER (To be completed in
full As Per HSA Offer)
To be confirmed in the name of (Required) *
Card Holder's Nationality (Required) *
Correspondence: Name and
postal address where documents
to be posted (Optional)
Card Holder's Passport No.
Please enter full names of all guests in the party including children (Required by law)
Please enter any further information/requests which we may require
(Required) *
I Disagree with HSA Terms and Condtions
I agree with Holiday Serviced Apartments Terms and Condtions
Link to HSA
Terms
and
Conditions