Name:

Address:

E-mail:

Telephone:

Mobile:

I wish to make a reservation at:
(please tick your choice of cottage)
Dolgeanu Hir, the barn
Lower Dolgenau, the cottage
The Town Cottage

For nights
from date
to date

My party consists of
adults and
children
aged

I shall be bringing a dog
I shall NOT be bringing a dog

A remittance of £, being 30% of the total accommodation charge of
£ has been forwarded by
cheque bank transfer

Cheques are to be made payable to Mrs Ruth Macklin Smith and forwarded to the above address.
Transfer Details for Ruth Macklin Smith:
6 digit sort code 309463
8 digit account number 21805768
BIC LOYDGB21365
IBAN GB56 LOYD 3094 6321 8057 68

I declare that I am over 18 years of age and understand that I am responsible for paying the balance of the total charge 28 days prior to arrival. I agree that I have read and understood your terms and conditions.

I heard about your cottages from:
Website (please name)
Brochure (please name)
Facebook
Other (please give details)