April Cottage

Langton Matravers

Dorset

Name: ____________________________________________________

Address: ____________________________________________________

____________________________________________________

____________________________________________________

Telephone No.: ____________________________ No. in Party: __________

My Party Comprises (please list names of all party members and age of children (add addresses, where different to the booking address):

Please indicate beds required 1 st Floor Double 1 st Floor Twin Beds Attic Double

Dates Required:

1 st ChoiceFrom _______________________ to ________________

2 nd Choice From _______________________ to ________________

Cost per Week£__________

Total Cost £ __________

⅓ Deposit enclosed £ __________ (non returnable) Cheques payable to: R.D. Jupp

Balance to Pay £ __________ Due 4 weeks before arrival

Signed: __________________________ Date: ________________

Return form to: Birchwood, East Stoke, Nr Wareham, Dorset BH20 6AN