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*First name: *Last name: *Street address: Address (cont'd): *City: *State/Province: *Zip/Postal code: *Country: Day phone: *Night phone: Cellular phone: Fax: *E-mail:
Reservation Information
Dates Requested (Check-in: 3 pm; Check-out: 10 am) *From the night of: Month Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 2004 2005 2006 *To the night of: Month Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 2004 2005 2006 *Number of adults: *Number of children: (age 5-12)
*From the night of:
Member of : © 2002 Tuwanek Place Cottage