Booking/Information Request Form      

        What would you like to do:  

                                        Make a Booking

                                        Confirm a previous booking
                                        Request for more information
                                        Have someone contact me

        Please provide your contact details:

First Name
Last Name
Title
Work Phone
Home Phone
FAX
E-mail

        Number of guests ?         Enter proposed arrival date : (dd/mm/yy)

                                        Enter proposed departure date : (dd/mm/yy)

        Please select the room of choice by entering 1, you may enter preferences1,2,3 etc:

Pref.	Room Name
	Victorian Bedroom
	Large Family Room
	Coxy's Room
	Cane Room
	Glenelg Room
	Annie's Room

 

If Confirming an existing booking you may enter your billing details here

	BILLING
Credit Card	VISA MasterCard American Express Diner's Club Discover
Cardholder Name
Card Number
Expiration Date

        Please add your comments or request for information