Safe or print this form, fill it out and send ir by: - post to: Hans-Jörg und Maya STALDER-REY Les Suis 83690 Villecroze, FRANCE - e-mail to: stalder.lessuis@free.fr (as an attached document). - fax to: 04.94.70.67.31 within France +33-4.94.70.67.31 from outside of France R E S E R V A T I O N =================================================================== Personal Information Last Name ----> First Name ---> Addresse -----> City ---------> Zip-code -----> State --------> Country ------> Phone --------> Fax ----------> E-mail -------> =================================================================== I would like to rent the: Holiday Apartment (4-5 people) from -----------> till -----------> Country House (2 people) from -----------> till -----------> Number of weeks -------> Number of people ------> =================================================================== Price - Payment (my calculation) Price total in Euro (weeks x Price / week) -----> Euro Advance payment: 30% at the reservation -------> Euro Payment rest: 70% cash at your arrivel: -------> Euro Prices in Euro / week Apartment Country House 01.04.2006 - 27.05.2006 450 Euro 350 Euro 27.05.2006 - 24.06.2006 500 Euro 400 Euro 24.06.2006 - 26.08.2006 650 Euro 450 Euro 26.08.2006 - 23.09.2006 500 Euro 400 Euro 23.09.2006 - 04.11.2006 450 Euro 350 Euro =================================================================== Brochure - Remarks Please send me a Brochure yes -------> no --------> Remarks -----> =================================================================== Thanks a lot for answering to all the questions ! With my signature I confirm that I have made this reservation and that I have read and hereby agree to all terms and conditions. City --------> Date --------> Signature ---> ===================================================================