Express Checkout | Avra Nafpliou

EXPRESS CHECKOUT FORM

Dear Customers, for our guests in a hurry, we offer the advantage of ExpressCheck-Out. This service is available in case of reception has already checked andaccepted your credit card. Please note that the final bill will be charged to the given credit card, without your personal presence.

First Name

Last Name

Name on Card

Billing Address

City

State

Zip Code

Phone Number

Email Address

Credit Card Type

Credit Card Number

CCV

Expiration Date (mm/yy)

Room Number

Departure Date

I agree that any charges applicable between submitting this form and the actual check-out will be charged on my credit card. I agree that any charges applicable between submitting this form and the actual check-out will be charged on my credit card. I Accept

Should you require a copy of this form in your inbox, please check the boxbelow and provide an email address. Should you require a copy of this form in your inbox, please check the boxbelow and provide an email address. Email me

Print Name

Signature

Date