If you want to make a reservation for the apartment in Ostia Lido, 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? e-mail: rome@stonehill.nl. If possible, I would like to reserve the apartment in Ostia Lido 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 103.267.018 of Rabo (IBAN: NL60 RABO 0103 2670 18; BIC: RABONL2U) in name of Willy Taroni-Blokzijl, 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.