1st Choice Dates:__________________ 2nd Choice Dates:__________________

Name:__________________________________ Address:_______________________________________________________________

__________________________________ __________________________________Tel.No:_____________________________

e.mail:_____________________________

No.of adults:__________ No. of children:____________Ages of children:____________________

No. of weeks:_____________ @ £______ per week totaling at £_________________________

Linen you are welcome to take your own: if required @ £6 per person totaling at £_________( a small towel is provided with the linen but all guests must bring their ownbeach towels and bath/shower towels...)

Please give estimated time of arrival (after 4.30pm):_________ Please give estimated time of departure:_____________

Departure before 10.30 am please so that we have time to clean and organize the space for the next visitors.

Winter fuel prices for gas and a few logs is £30 plus we now take a deposit of £100pw (you will only have to pay for your use during the Winter by reading the meter at the start and end of your holiday + will receive a refund if you use less than £30 worth) The first 100 units of electricty per week is included in the price. The whole deposit will be refunded if you have not used extra electricity

For the rest of the year the electricty and gas is included in the price...

Would you liketo join our Mailing List for monthly special offers and Late Availability yes/no

A reminder that Casa Ana is a non smoking house...and sorry no no pets are accepted.

Cheques should be made payable to: Anna Kavanagh and sent with the booking form to:

Trallwyn Uchaf, Mynachlogddu, Clynderwen, Pembs., SA66 7SE. Telephone: (01994) 419 278.

The deposit required is £100 per weeks holiday booked.

I enclose my deposit of £100/Full Payment : £_______ I have read and agree to abide by the booking conditions

I am paying by Bank Transfer £________ I am Paying by Paypal__________

I understand that the remainder of the total price of the holiday is due 8 weeks before the beginning of the holiday.

Signed:....................................................... Date:.............................................

Information helpful to us: Can you recall where you first heard about us?

Newspaper/magazine: ___________________________Internet/Other/: __________________________Through friends:

_______________________________Would you be happy to display an ad at work or elsewhere? _________

If so how many would you like? __________________________