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Field marked with (*) are required
*First Name:
*Last Name:
Title:
*Company Name:
*Address:
Address:
*City:
*State/Province:
*Zip/Postal Code:
*Email Address:
*Phone:
Fax:
 
General Information
Date by which the proposal must be received:
Name of Meeting/Event/Function:
Brief Description of Meeting/Event/Function:
Event Information
*Arrival Date:
*Departure Date:
Are these Dates flexible? (yes/no)
Alternate Dates if any:
Meeting Room Block
Date
Start Time
End Time
No. PPL.
Setup Type
1.
2.
3.
4.
5.
Audio Visual Notes
Please indication any
special Audio Visual
requirements.
Accommodations Information
*Arrival Date:
*Departure Date:
Sleeping Room Block
Date
Singles
Doubles
Suites
Total
1.
  
2.
  
3.
  
4.
  
5.
  
Grand Total
*
Other Information
Private dining events description:
Hospitality suite requirements:
Other important requirements:
(ie: Golf, video conferencing,
fitness center, etc.)
My preferred method of communications is: Email      
Home Phone     
Mail     
Fax
 



Phone : 91 022 67978090 |   Fax : 91 022 2528 4058|   Opp. Chembur Railway
Station. Chembur. Mumbai-400071  |   Email: sales@rajhanshotel.com

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