Your Name (Mr/Mrs/Ms/Miss).................................................
Address.............................................................................
....................................................................................
....................................................................................
Post Code...................................................... Telephone No. Work....................................Home..........................................

Proposed holiday......week(s)

from Saturday the .... of .......... to Saturday the .... of .............

Which Cottage?

(please delete)....Stables/Nutmeg/Skyber 

People in your party:-

 Adults ........(In.....double &.....single beds) 

Children .....(Aprox ages please...................) 

Babies.....(I do/do not require cot/highchair)

Do you wish to bring a pet (No extra charge but certain rules apply)

Yes/No 

Total Cost of accommodation £........

Deposit (being 1/3 of total) £........ 

I enclose a cheque (payable to CA & M Purdue) for the deposit / I wish to pay the deposit by credit/debit card ( please delete as appropriate)

Credit/Debit Card No. |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |   |

Valid From: |   |   /    |   |                         Expiry Date  |   |   /    |   |

Issue Number: (Switch only)     |   |  

Sec Code(Last 3 digits on reverse)     |   |  

Cardholders Name:  .....................................................