Name:
E-Mail:
Number in Party:
Dates Required
from:
to:
Address:
september - june: rental @ £165 per week
£
july - august: rental @ £190 per week
£
TOTAL RENTAL
£
Refundable Deposit
£    50


I enclose a booking deposit for £ ________ being 20% of the total rental.
I agree to pay the balance of £ ________ at least three weeks before date of rental.
I also enclose a separate cheque for the £50.00 refundable deposit.
I understand that my cheque for the refundable deposit will be sent back to me on the return of the key by recorded delivery and provided the flat is left in good order, clean and ready for the next occupants.

NB Unfortunately, due to the inconsiderate behaviour of one group of visitors last summer, I regret that your deposit will also be forfeit if I receive any complaints of rowdy or antisocial behaviour from the neighbours.

Signed:
Date:


Please print-out and return this form, signed and dated, together with the two deposit cheques to:

M.E.Birch, Bolkstraat 14 - 2E, 1097HG, Amsterdam, Netherlands
Cheques should be made payable to M.E.Birch

If you wish to pay by some other method - e.g. PayPal or bank transfer - please contact me either by telephone or e-mail

You can also download and use our PDF form here if you prefer