Request for Reservation
 
First name:
Last name:
Phone Number:
Fax Number:
E-mail address:
Hotel (accommodation):
Arrival date on Bonaire:
Departure date from Bonaire:
   
I would like to reserve:
a Cell Phone, for on date: for:
   
Terms: A deposit on the phone will be held against the credit card you provide, as well as the fees for the phone use. Upon arrival in Bonaire, you are required to visit Chat 'n' Browse to sign your authorization for any charges.
   
I agree to the terms as stated above and agree to abide by them. (Note: Rental will not be confirmed unless "I agree" is selected.)
   
Creditcard number:
Creditcard exp. date:
   
Additional comments:
   


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Kaya Gobernador N. Debrot #79
Sand Dollar Shopping Plaza

(Next to Lovers Ice Cream and the Sand Dollar Grocery)
Bonaire, Netherlands Antilles
Phone/Fax: (599) 717-2281

 

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