Application for the hotel number in the hotel "Gluhoman"

Please, fill in your Application: fill in the corresponding fields of the form and then press "Send".

Please, fill in necessary contact information for senging your Application:

Name, last name*

Your address:

Date of arrival:*

Date of departure:*

Category of hotel number:

The form of payment:

The contact person:*

Phone (s) with the indication of codes of the country and city, (it is desirable to specify mobile)*

E-mail:

Additional requirements:

Date of registration of the Application:

It is fielled automatically at sending of the Application

Enter an above mentioned code

Before to press the button "Send", check up correctness of dates of arrival and departure.

Note. The data designated by a badge *, is obligatory for filling the form.
2. To be convinced of that your Application sent through the Internet is accepted, call by phone +38 0532 68-90-99;
+38 (0532) 57-07-90;
+38 050 850-3-555 .

The price list for residing and services in restaurant - hotel complex "Gluhoman"

Ресторан, гостиница, баня на дровах, Полтава

© Gluhoman, 2009
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