Pacific Lots of Costa Rica - Client Visit Application (CVA)

3-day, 2-night Guest House Visit

Click here for the 10-day escorted Costa Rica Discovery Tour CVA

If you have any questions contact Peter Masse
Phone: 978-239-4718
Email: Peter@pacificlots.com

Please complete this form and fax to 877-481-0300

Welcome,
We're happy you'll be joining us for a 2-night stay at our Guest House. We will prepare for your arrival and confirm with you all of your reservations. If you are taking the commuter flight from San Jose to our area in Palmar Sur a member of our staff will meet you at the local airport.

A valid passport that will not expire within 90 days of arrival is required for travel.

Please be prepared. To reserve a property of your choice a 10% deposit is required. We regret that no properties can be reserved without a deposit and we respectfully request that you bring your checkbook to avoid disappointment.

Contact Information

First Name___________________________Last Name _________________________________

Address ____________________________________________________

City _____________________________

State / Province ________________ Zip / Postal code ________________Country ____________

Home Phone ________________________________

Cell Phone / Other ________________________________

Fax Number _____________________________

E-mail ______________________________________________

Travel Information

Number of people traveling with you _____Number of rooms required for your 2 night stay ______

Names of people traveling with you (Children under 12 years old are NOT permitted at the Guest House)
Contact us for other options if you want to bring children.

____________________________ ____________________________________

________________________________________________________________

________________________________________________________________

Smoking ________________________

Culinary requirements (i.e., aversions, allergies, vegetarian, etc.) : ____________________________________

Please contact us for Guest House availability BEFORE booking your flight to San Jose.

Arriving (San Jose): Airline __________________________ Flight # _______ Date ___________ Time __________

Departing (San Jose): Airline _________________________ Flight # _______ Date __________ Time __________

Payment Options

Credit Card (Visa, MC, AMEX)
If you would like to pay the $500 visit fee by credit card, please fill in the following information

Name on Card____________________________________________________________________

Mailing Address of Cardholder_______________________________________________________

Type of Credit Card__________________

Card Number____________________________________________________________________

Expiration Date_____________       CID (3-digit security number on back)___________________

Check
If paying by check, please make $500 payment to Pacific Lots and mail payment to:
Pacific Lots, PO box 6283, Key West, FL 33041

Would you like us to make hotel reservations for your arrival night in San Jose?   YES / NO   (circle one)

If yes, would you like us to reserve a 3-star hotel (approx. $60/night) _____ or a 5-star hotel (approx. $120/night) ____

If no, where are you staying in San Jose? ______________________________________________

Phone Number ____________________________

Would you like us to make commuter flight reservations from San Jose to our properties (Palmar Sur)? YES / NO

Credit card type __________ No. _______________________________CID Sec. Code_______ Exp. Date ______

Which 2 days would you like to stay with us?
(month/day) ___________________ and ________________________

**Note: Cancellations made on hotel within 3 days of arrival, or on commuter flight (Sansa) within 10 days of flight, will NOT be eligible for refunds.**

If you have already reserved a property, which Phase/Lot # _____________

Additional Comments: