General 2 — Maison Nationale

Give someone a dream night (worth €175) or choose the value of your voucher.
Extra: with breakfast +€19.50 per person.

The lucky receiver can contact MAISON NATIONALE to redeem the voucher and make a direct reservation.

Payment options:

Mastercard/VISA : credit card + expiry date
by bank transfer to KTL Projects BVBA / Maison Nationale
Account number : IBAN BE 58 0688 9773 0579, BIC : GKCCBEBB
Reference : gift box
Total : € ...
Cash in the lobby at MAISON NATIONALE (by appointment)

Name of the donator

First Name

Last Name

Email

Phone

Country

(###)

###

####

Name of the lucky receiver

Amount of the gift voucher

Dream Night worth 175 euro

Other amount

Gift voucher amount (€) amount (if you chose 'other amount')

Receive your voucher

Send the voucher to my address

Send the voucher to the beneficiary

I will collect the voucher at Maison Nationale

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Personal message for the receiver