Booking Form
for                                                                
Apt 12, Square Pauline, Boulevard Raymond Poincaré, 06160 Juan-les-Pins, France

Payments can be made either:
                direct in euros: we will send you details of our bank account so that you may make a direct transfer                          from your bank account to ours
                or you can send a euro cheque, made payable to "Andersen & Picque", to:
         Anna Andersen, Andersen & Picque, villa n.16, 292 chemin de Valbosquet, 06600 Antibes, France
.

Please print, complete this form by hand, scan it and then e-mail it to:
pwilcox@blueyonder.com

Block Capitals please
FULL NAME …………………………………………………………………………

ADDRESS (including postcode)……………....…………………………………………..

…………………………………………………………………………………………

HOME TEL NO……..……………………… DAY TEL NO……………………….

MOBILE NO……………………………….. EMAIL ……………………………...

RENTAL PERIOD: ………………………………………………………………….

NUMBER OF PEOPLE IN YOUR PARTY:  ADULTS: ….    CHILDREN :……

TOTAL RENTAL COST                €…………………
25% DEPOSIT                                €………………… 
                                                          ------------------     
BALANCE OF RENTAL                €…………………
SECURITY DEPOSIT                     € 500.00                 (or sterling equivalent)
                                                          ------------------
BALANCE PAYABLE                    €………………… 
        (Payable four weeks before rental period commences.)

N.B. The 25% deposit which is required before a booking can be confirmed is non-refundable. You are advised to take out a Travel Insurance Policy with a Cancellation Clause, which may enable you to recover non-refundable monies.

Linen required - 15€ per person? Yes ⊂⊃    No ⊂⊃
Final cleaning required - 60€?       Yes ⊂⊃    No ⊂⊃

I HAVE READ THE ATTACHED TERMS AND CONDITIONS AND ACCEPT THEM ON BEHALF OF ALL MY PARTY WHO WILL RESIDE IN THE PROPERTY, ON WHOSE BEHALF I AM DULY AUTHORISED TO MAKE THIS AGREEMENT. I AM OVER 18 YEARS OF AGE.

DATE ………………...............................SIGNED …………………………………............................................
                                                                   PRINT NAME ……………………………..........................................

NOTES:  Rental Periods start on a Saturday at 4.00 p.m.and end on a Saturday at 10.00 a.m.
                Where additional charges arise, they must be paid before departure.