Costa Rica-Net-Guide fax form

In order to guarantee reservation for any of the services offered here, please PRINT and fill up this form and send it to our fax number : (506) 297-1993

Credit Card bearer's name (As it appears on the credit card)

Credit Card Number

Type of Card (Visa, Amex, Master)

Expiration Date

Amount to be charged in us$

Signature As it appear on the credit card

I will not accept any charge different from the one mentioned above using this form.

Service required

In order to guarantee reservation for any of the services offered here, please PRINT and fill up this form and send it to our fax number : (506) 297-1993

For additional information or comments
please e-mail to crnguide@costarica-net-guide.com

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Credit Card bearer's name (As it appears on the credit card)
Credit Card Number
Type of Card (Visa, Amex, Master)
Expiration Date
Amount to be charged in us$
Signature As it appear on the credit card
I will not accept any charge different from the one mentioned above using this form.
Service required

For additional information or comments please e-mail to	crnguide@costarica-net-guide.com