If you want to make a reservation for the apartment (ground-floor)
in Ostia-Antica, please print this form on your printer, complete it
in block-letters, and send it to:
 
Dolly Steenbergen
Boterstraat 12
(NL) 6701 CW Wageningen
The Netherlands
 
Any questions? email: rome@stonehill.nl. 

 
If possible, I would like to reserve the apartment (ground-floor)
 
in Ostia-Antica. Date of arrival:        date of departure:
 
Name            :                 Phone/GSM        :
 
Initials        :                 Email address    :
 
Address         :                 Bank account     :
 
Zip code + City :                 IBAN             :
 
Country         :                 BIC              :
 
 
I have transferred bail + charge for cleaning + use of linen
to bank account 539.149.187 of ABN-AMRO
(IBAN: NL74 ABNA O5391 49187; BIC: ABNANL2A) in name of M.L.Reuter,
Wageningen, the Netherlands and I am obliged to make sure the rest
of the money is transferred at latest 1 month before the beginning
of the holiday to this bank account.
 
In case of TIMELY cancellation the advanced money
will be returned immediately to my bank account.
 
 
We travel by
( ) plane to airport Ciampino/Fiumicino/unknown
( ) car
( ) train
 
 
We are with       persons.
 
 
Dates of birth: .. - .. - .... ,  .. - .. - .... ,  .. - .. - .... ,
 
 
                .. - .. - .... ,  .. - .. - .... ,  .. - .. - ....
 
Date:                             Signature:
 
 
PS: After payment of the bail etc.
you will receive a confirmation.