Name:

____________________________________________

Address:

____________________________________________

 

____________________________________________

Town:

____________________________________________

County:

____________________________________________

Postcode:

______________________

 

Daytime telephone number (including Std Code):           ___________________

Evening telephone number (including Std Code):            ___________________

 

Number of nights:  ______       Starting date:  __________      Ending date:  __________

Total number of adults ______ Total number of children (Under 16 years) ______

 

Accommodation Requirements.

 

Number of double rooms required = _____

(Only 1 double room available).

 

Number of twin bedded rooms       = _____

(Only 1 twin bedded room available).

 

Number of single rooms required  =  _____

(Only 1 single room available).

 

 

 

 

Number of adults:

_____ @ £ 20.00   x  _____ nights =

£ ____________

Adult Evening Meals:

_____ @   £ 5.00   x  _____ nights =

£ ____________

Number of accompanying children:

_____ @  £  9.00   x  _____ nights =

£ ____________

Children’s Evening Meals:

_____ @   £ 3.00   x  _____ nights =

£ ____________

 

 

 

Total Cost of holiday =

£ ____________

Less 10% deposit =

£ ____________

Overall outstanding balance to pay  (no later than 14 days prior to commencement) =

£ ____________

 

Please complete this form and sent it along with your deposit to.

 

Mrs. J Williams

Brightlycott Cottage

Shirwell Road                           (Please make cheques payable to: Mrs. J Williams)

Burridge

Devon.

EX31 4JJ

 

If you would prefer confirmation of this booking via email then please enter your email address:

                        __________________________________________________