Exeltis Credit Card Authorization Form

To confirm your extended stay dates at Excelsior and/or Ambasador hotel, please complete the entire form below.

Your information will remain private and will not be shared with other companies, individuals or organizations, except as required for your hotel reservations as requested.

Name as shown on credit card*
First Middle Last
Address associated with card*
Street Address City State / Province / Region ZIP / Postal Code Country
Authorization Amount EUROS*
I authorize Adriatic Experience to guarantee hotel reservations up to the amount specified to the credit card listed below. Enter amount in EUROS.
Credit Card Number*
VISA, Master Card & American Express cards are valid. Debit cards cannot be processed.
Security Code on back of card*
Expiration Date*
MM slash DD slash YYYY
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- First Choice
- Second Choice
- Third Choice