WESTLAND HOLIDAY FLATS
Proprietors K.B.& J.M. Hancock
Northbrook Road, Swanage, Dorset, BH19 1PS

Telephone 01929 422637 .... E mail enquiries@westlandflats.co.uk
Booking application form
Please complete and then print out this form and send back to us by by conventional post

DATES
1st choice arrival. Departure
2nd choice arrival Departure

NUMBER OF FLAT 1st choice ....2nd choice

1 Title Initial Surname Age if under 18
2 Title Initial Surname Age if under 18
3 Title Initial Surname Age if under 18
4 Title Initial Surname Age if under 18
5 Title Initial Surname Age if under 18
6 Title Initial Surname Age if under 18

Bed Linen required .........If yes Number of Beds (not people) ....Doubles ....Singles
Cot Required .....Highchair Required
Central Heating Required
Space for ONE car........ If yes
............Make Model
Body type eg hatchback, estate

I have read and agree to the terms & conditions of booking
Your name Date
Address 1.
Address 2.
Address 3.
Town/City. Country..
County ...... Postcode
Telephone Number ....Mobile Number
Email Address.......
Do you prefer to receive all details by Email

Deposit / Full payment of enclosed Please make cheques payable to K. B. Hancock

Have you stayed with us before ...How did you discover our website
The owners reserve the right to refuse the application without stating a reason



Card Logo
We are pleased that we are now able to offer a facility to make payments by most Credit or Debit cards at a

1.5% premium for Credit cards and a fixed 0 fee for debit cards.

If you would like to take advantage of this facility please complete your details in the form below and return with your booking form.

For security please fill in the card details below manually after printing the form

Card type....Debit....Credit..(delete as required)

Name as it appears on the card. .............................................

Card Number..............................................

Start Date. ........................ .or Issue Number. ......................

Expiry Date. .......................

3 digit security code.................... last 3 digits on the signature strip
Address that the card is registered to if not the same as on the booking form

Address 1..............................................

Address 2..............................................

Address 3..............................................

Town/City..............................................

County .............................................

Country ............................................. Postcode .............................................

I agree for you to debit the card above for my holiday deposit/ full payment/ final payment plus the fee as outlined above.

Signed............................................. Date....................