Hotel Sovereign Clichy

To reserve your room please fill out the following form which we will return with a confirmation:

First name:

Surname:

Address:

Zip code:

City:

Country:

Phone:

Fax:

E-mail:

Room type:

Number of nights:

Payment
Master card CB JCB VISA American Express Diner's Club	Card Number:
	Expiration Date:

Date of arrival (dd/mm/yy):
Date of departure (dd/mm/yy):

Comment: