The Perfect Cottage Booking Form

Please complete as much of the form as possible. Make sure that you at least complete the items marked with an asterisk (*). When you've finished filling in the form, click on the Send button.

Booking Details
Cottage:
Number People:	*
Number of Nights:	*
Required Arrival Date:	*
Contact Details
Title (Mr, Mrs etc.):	*
First Name:	*
Last Name:	*
Address:	*
Town/Suburb/City:	*
Postcode/Zip Code:	*
Email Address:	*
Phone (daytime):	*
Phone (evening):
Fax:
Optional Information
Choice of meal and wine for arrival: Fish Pie, Lasagne, Chicken or Beef Casserole, Vegetable Bake. All dishes are served with fresh vegetables and cost £8.95. La Vielle Ferme Cote du Rhone Red or White £6.00
Any other requests:
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