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Booking Form for Shillings Cottage

Please complete and return this form by post to:

Diana Elliott
Shillings Cottage
Pounds
Hemyock
Cullompton
Devon EX15 3QS

Agreed booking dates from ________________________ to ______________________

at an agreed booking cost of £_______________________________________________


Details of the person placing this booking -

Title: (Mr/Mrs/Miss/Ms/Other*) *please specify __________________________________

First name _______________________ Last name _______________________________

Address __________________________________________________________________

_______________________________________________ Postcode __________________

Telephone _________________________ email _________________________________


Number of adults ________________ Children _____________ Cot required Yes/No

£100 Deposit enclosed (cheques made payable to Diana Elliott)

Signature _______________________________________________________________

It would be helpful if you would let me know where you heard about the cottage.

_________________________________________________________________________


Thank you for your booking.