ESPERAZA SQUARE, ESPERAZA, FRANCE
Tel: +33 (0) 468 20 11 42  E-mail: sophie@esperaza.info Website www.esperaza.info

BOOKING FORM

Arrival date……………………….. Departure date……………………………..

Expected time of arrival………………….. Expected time of departure…………………..

Travel insurance: Company……………………….. Policy number………………………..

We would like to have linen provided (including towels, duvets, sheets and pillows) at a charge of 10 euros per person per week. Yes / No
We have already decided that we would like the cleaning service for 30 euros . Yes / No
Please describe required travel information (eg. Rail, directions from Paris)

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I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . wish to book 4 rue Barbès, Espèraza, Aude, 11260, France from and to the above dates. Please find enclosed a cheque for the rental period to confirm our reservation. I agree to abide by the terms and conditions set out above and declare that I am authorised by the person(s) named below to effect this reservation & accept liability/conditions on their behalf.

Address for all correspondence: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Signed . . . . . . . . . . . . . . . . . . . . . . . . . . . Date. . . . . . . . . . . . . . . . . . . . . . . . . . . . . e-mail. . . . . . . . . . . . . . . . . . . . . . . . . . . . . Tel: Home. . . . . . . . . . . . . . . . . . . . . . . . . . Tel: Work. . . . . . . . . . . . . . . . . . . . . . . . . . Tel: Mobile. . . . . . . . . . . . . . . . . . . . . . . . .

Persons who will be staying in Apartment:
SURNAME, FORENAME, AGE (if under 18), NATIONALITY, PASSPORT NO.
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Please post to: Sophie Duncan, Le Village, Saint-Ferriol, 11500 Quillan, France
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For office use only		Meter reading on arrival	......................
Receipt sent	......................	Meter reading on departure	......................