If you want to make a reservation for the apartment in
the Centre of Rome, 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 the Centre of Rome
 
Date of arrival :                 Date of departure:
 
Name            :                 Phone/GSM        :
 
Initials        :                 Email address    :
 
Address         :                 Bank account     :
 
Zip code + City :                 IBAN             :
 
Country         :                 BIC              :
 
 
I have transferred 20% of the rent to bank account 92.33.27.258 of ING
(IBAN: NL35 INGB O923 3272 58; BIC: INGBNL2A) in name of D.Steenbergen,
Wageningen, the Netherlands and I am obliged to pay cash the rest of
the money (80% of the rent) immediately when I have arrived at the apartment.
 
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 advanced money
you will receive a confirmation.