Nicole CASTAIGNOS
Hameau "Les Sias"
26170 La-Roche-sur-le-Buis - Drôme Provençale - France
Tél. et Fax : 33 (4) 75 28 03 95
Email
Warning :
This form allows you to request a booking. Your booking will become operative only after the contract sent by mail, is filled and returned.
Please fill in all the items to be served at best. Thank you.
BOOKING FORM
* Name
* First name
Company
* Adress
* Zip code
Or Postal code
* Town
* Country
* State
* Home phone
Work phone
Fax.
* Email
PERIOD
du
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January
February
March
April
May
June
July
August
septembre
October
November
December
2008
2009
2010
2011
2012
au
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January
February
March
April
May
June
July
August
septembre
October
November
December
2008
2009
2010
2011
2012
Number of persons
Adults
Children over 3
Children under 3
Selected flats and houses (in order of preference)
order of preference
Furnished Flats
1
Preference 1
Le Myosotis
La Pervenche
Le Bleuet
La Rose Tremiere
La Campanule
L'Angelique
2
Preference 2
Le Myosotis
La Pervenche
Le Bleuet
La Rose Tremiere
La Campanule
L'Angelique
3
Preference 3
Le Myosotis
La Pervenche
Le Bleuet
La Rose Tremiere
La Campanule
L'Angelique
4
Preference 4
Le Myosotis
La Pervenche
Le Bleuet
La Rose Tremiere
La Campanule
L'Angelique
5
Preference 5
Le Myosotis
La Pervenche
Le Bleuet
La Rose Tremiere
La Campanule
L'Angelique
6
Preference 6
Le Myosotis
La Pervenche
Le Bleuet
La Rose Tremiere
La Campanule
L'Angelique
Remarks
Conception et réalisation :
Agence Web 26
