Name:
Address:
Telephone:
E-mail:
Date of Travel:
Duration:
No. of people travelling:
Type of accommodation reqd.:
Self-catering
Bed & Breakfast
Specific reference number:
Booking Deposit (50%):
Payment by:
Cheque
Credit Card
Cash
Credit Card Number:
2.5% charge for credit card bookings
Special Requirements:
Note: When you have entered all the details on the form, print it out and fax it to us at
353 -21-4774727
. Credit card bookings can be submitted on-line, but please note that the form is not secure and the credit card information could
theoretically
be intercepted by a third party.