Your Name *

First Name

Last Name

Contact Phone Number *

(###)

###

####

Date of Event *

MM

DD

YYYY

Time of Event *

Hour

Minute

Second

AM PM

Card Billing Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Authorization *

I authorize Cucina Alessa to charge my credit card as a deposit for my event on the date and time listed above. The amount will be $10 per guest in the party. I am aware that my deposit will be processed and applied towards the final bill and will only be refunded if the even is canceled 20 DAYS prior to the event, except for July, August, and December, where the cancellation must be made 30 DAYS prior to the event.

I Agree

Please Call me for Credit Card Information