Les Charrieres Hotel Enquiry Form

Title Please select Mr Mrs Miss Ms

First name

Surname

Address

Email

Daytime Telephone

Evening Telephone

Mobile

Departure Airport or Port

Room Type Please select Double private facilities Double private facilities with balcony or patio Twin private facilities Double private facilities with balcony or patio

Arrival Date DD 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 MM 1 2 3 4 5 6 7 8 9 10 11 12 YYYY 2011 2012

Duration of stay Please select 1 night 2 nights 3 nights 4 nights 5 nights 6 nights 7 nights 8 nights 9 nights 10 nights 11 nights 12 nights 13 nights 14 nights

Number of adults Please select 1 2 3 4 5 6

Number of children Please select 0 1 2 3 4 5 6

Message

We may use the above information to contact you with future brochures and details of other products and services offered by Travelsmith. We will NOT pass on your details to any third party companies which are not part of the Travelsmith group. Please state if you do or do not wish to receive such information. I do not wish to receive such information I do wish to receive such information