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Please print off, fill in and return with Good Will Deposit of £50.00
Date of Arrival Day Date Month Year
Date of Leaving Day Date Month Year
Duration of stay 1 WK 2 wk W/end other (state)
Rate for above stay £ Sterling/ Euro
Number of occupants 1 /2 / 3 / 4 / or more (please state) any babies
If you are bringing babies; please circle from the following what you would like us to provide;
Travel cot / cot bedding / highchair / baby bath
Your Details (please print clearly)
First name/s __________________Surname __________________________
First line or address ________________________________________________
Second line of address _____________________________________________
Town / City _______________________________________________________
Postcode _____________________ Country ____________________________
Home phone number (inc code) ________________Mob ___________________
Email address _____________________________________________________
How did you hear about Glebe Cottage? Website / holiday brochure / recommended by friend / other
I am over 18 years of age (tick if appropriate) I agree to the booking terms (tick if appropriate)
Method of payment: cheque / visa / direct transfer: Please send your deposit with this form completed to:
Marie Stitt
67 Hartswood
CRUMLIN
BT29 4PY
Within 7 days from postmark.
Thank you for your booking and we will send you confirmation and a receipt.