Submit this Confirmation Form

By filling in and submitting this form, I authorize MidTown Hotel (s.a.l.) or Serenada Tourist (s.a.l.) to make a one time debit to my credit card listed below, as full advance payment of my stay at Golden Tulip in Beirut, Lebanon.  This is permission for a single transaction only, and does not provide authorization for any additional unrelated debits or credits to my account.
I certify that I am an authorized user of this credit card and that I will not dispute the payment with my credit card company; so long as the transaction corresponds to the terms indicated in this form.
MidTown Hotel (s.a.l.) and Serenada Tourist (s.a.l.) can only process credit cards (cannot process debit cards).  The US Dollar is the primary currency used in the hotel.  The only alternative currency is the Lebanese Lira.  MidTown does not accept Euros or other currencies.

Name As it Appears on Card (card has to be in bookers name)
Check in Date
Your Phone Number (please enter country and city code)
Card Type (Please enter: Visa, Master Card or Amex)
Expiry Date
Authorized Amount of Withdrawal
3 or 4 digit security code on card back (CVC2)
Please Specify Hotel: MidTown or Serenada
Booking Reference Number
Enter Credit Card FIRST Eight Digits (ex: 1234-1234)
Enter Credit Card LAST 8 Digits (ex: 1234-1234)