To hold a reservation, please submit this secure rental application with your request. All of the information provided will be kept in strictest privacy and not provided to anyone, ever. We will hold your requested dates for 5 business days until receipt of $250 security deposit (cashier's check or money order only please). Upon receipt of the application form, we will send you contracts and the address to send the deposit. There is no obligation until acceptance of contract.

Please provide the following information for each guest. Please provide age for any persons under 18.

* = Required Field

Please choose desired property:

Number of Adult Guests: Guests under 18 yrs:
* * *  
Arrival Date (month / day / year): Departure Date: Total Nights:  
*
* *  
Name Guest1: Age if under 18: Total No. of Vehicles:  
*
*  
Address:
*
City: State: Zip Code:  
*
* *  
Day Phone: Eve Phone: Cell Phone:  
*
*  
FAX: Email:
*
Name_Guest2: (enter "none" if no 2nd guest)
Age if under 18:
*
Name_Guest3: (enter "none" if no 3rd guest)
Age if under 18:
*
Name_Guest4: (enter "none" if no 4th guest)
Age if under 18:
*
I plan to pay the rental fees by:
*

Date you depart home:

Airport of Arrival: Airline Flight Arrival Time:

Date you depart property: Airport of Departure: Airline Flight: Departure Time:

Date you arrive back in USA:      
     
Employed by: Title:    
   
If self-employed or retired from:      
Company Name: Nature of business:  
Address:
City: State: Zip:  
 
Work Telephone:    
   
Do you speak French? Other languages? (please specify)
Please list any special needs or interests:
How were you referred to us? If personal referral or other, please specify:
*
In Case of Emergency Notify:      
First Name: Last Name:    
   
Relationship: Day Phone: Eve Phone:  
 

All of the information above will be kept in strict privacy and not provided to anyone, ever.

Upon acceptance of contract by guest, rental fees are due 60 days before the first night's stay.

To save a copy of this information, print prior to submitting