Confirmation form for Domaine de Saint-Apolis
FAX to: +33 (0) 4 67 77 78 33
Please fill the boxes below, print, sign and fax to the above number.
Personal details:
Surname:
Fisrtname:
Post Code:
City:
Address:
Country:
Telephone number:
E-mail:
Property details:
Arrival Date:
Departure Date:
Extra :
Number of bedrooms:
Adults:
Children:
Classique :
Number of bedrooms:
Adults:
Children:
Payment details:
Total cost of stay:
€ Amount payed today:
€
Please fill in one of the boxes below - this will be the amount we will take as a payment.
Deposit of 30%
Balance of 70%
Full payment
Credit Card:
Visa
Mastercard
Other (specify) :
Credit card number:
Three last digits:
(security code now found on the backs of most credit cards)
Expiration Date:
Cardholder's name and address:
(If different from above)
Signature:
Date :
Rental conditions:
A 30% non-refundable deposit is required when confirming the booking and the remaining 70% due 8 weeks prior to arrival.
A security deposit of 300 Euros is required on arrival - refunded on departure.
No pets allowed. Long stay rates negotiable during low season only.
We strongly recommend cancellation & travel insurance to prevent any losses in case of illness, accident, or otherwise.