Please tell us
about Yourself.
|
| Title (Mr, Mrs, Ms, Dr) |
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| First Name or Initials |
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| Surname |
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| Address |
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| Country |
|
| Postcode/Zip |
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| Contact Telephone Number |
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| Email Address |
|
|
| Accommodation Required |
|
|
Cottage
Bed & Breakfast |
|
| Bed & Breakfast |
|
| Which rooms would you like to book. |
Ensuite Double
Double
Twin |
| Choice of Cottage |
|
| First Choice |
|
| Second Choice |
|
| Dates of Stay |
From
To
|
| Other members of your
party |
(Please state full name and age for each.) |
|
|
| Payment |
|
| Cottage Rental Week 1 |
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| Cottage Rental Week 2 |
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| Cottage Rental Week 3 |
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| Special requirements, or other enquiries.
|
|
Please
make cheques payable to
Penny Adie |
Declaration
By submitting this form, you are declaring that you are over 18 years
of age and fully accept and will abide by the booking conditions laid
down in the Conditions of Booking
Page. |
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|
|
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Please feel free to print this form out and fax it to
the number shown below, or send it by post to the address shown.
Barkham, Sandyway,
South Molton, N.Devon, EX36 3LU
Telephone: 01643
831370 (International: 44 1643 831370)
Fax: 01643 831370
(International: 44 1643 831370)
email us at:
adie.exmoor@btinternet.com
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