-------Hotel Reservation Form(Tsukuba Daiichi Hotel)--------

Family name(print)______________________Given name____________________

Address____________________________________________________

Phone____________________________________

Fax_______________________________________

E-mail_____________________________________

Check in___________________

Check out__________________

Guaranteed by credit card

Type of Card (VISA, Master, etc.) _________________

Number____________________________________________

Expiration Date________________________________

Card Holder Name___________________________________________

Signature___________________________________________

Date___________________________

*No reservation is made with the absence of the credit card 
guarantee..