LES CONCHIS


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RESERVATION REQUEST FORM

This form is a request form only. It will go into effect upon your acceptance of
our proposal and your payment of a 30% deposit

Name (last name, first name):
Company:
Address :
Postal code :   City/ Town:
Country:  
Telephone:
Fax :
E-mail :
Arrival date (day / month / year)*:
Departure date (day / month / year)* :
* for weekly rentals of the cottage,
Number of nights:
Number of persons:

Comments :

Maurice et Madeleine LUCIEN-BRUN
Les Conchis
07110 SANILHAC
Tel and Fax : 33-(0)4.75.39.16.78

E-mail : les.conchis@wanadoo.fr