Booking Enquiry Form . . .

Please complete this form and e-mail it to us, or if you prefer print out this form and fax it to
+ 44 (0)1534 639 640

We will contact you at the first opportunity to confirm if your chosen dates are available, or alternatively offer you available dates close to your preferred dates, we may need to speak to you to clarify some details before we are able to offer a firm estimate.

Principal member of your party (Fields indicated in red are obligatory)

Your Full Name: Email address: Address Line 1: Address Line 2: Address Line 3: Address Line 4: Post Code: Day Telephone: Evening Telephone: Mobile Phone: Facsimile Number:
Other members in your party
Name:		Age:	Select 1 - 3 Yrs 3 - 8 Yrs 8 - 16 Yrs Adult
Name:		Age:	Select 1 - 3 Yrs 3 - 8 Yrs 8 - 16 Yrs Adult
Name:		Age:	Select 1 - 3 Yrs 3 - 8 Yrs 8 - 16 Yrs Adult
Name:		Age:	Select 1 - 3 Yrs 3 - 8 Yrs 8 - 16 Yrs Adult
Name:		Age:	Select 1 - 3 Yrs 3 - 8 Yrs 8 - 16 Yrs Adult
TOTAL NUMBER OF PEOPLE IN PARTY Maximum 6 people
Dates required (1st Choice)
From dd/mm/yy - To dd/mm/yy
Dates required (2nd Choice)
From dd/mm/yy - To dd/mm/yy
Special Requirements
Hire Car Details
1st Choice - Group Type of Car
2nd Choice - Group Type of Car
Do you require any of the following Extras
A Welcome Pack upon your arrival - (please see our Tariff page)			Select Yes No
A Cot - (please note - Cot hire is £10.00 per week)			Select Yes No
A High Chair - (please note - High Chair hire is £5.00 per week)			Select Yes No
Our Marketing
Thank you for taking the time to fill in and submit this form, please would you be kind enough to indicate how you heard about Vivenda Mimosa
Please Select How -- Search Engine -- Alta Vista AOL Ask Jeeves Freeserve UK Lycos MSN Yahoo Other Engine -- Newspaper -- European UK Regional -- Magazine -- Choice villas & Apartments Holiday & Leisure World The Lady -- Word of Mouth -- Friend Relative Work Colleague Email Website Advertising Other source
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