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.
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
January
February
March
April
May
June
July
August
September
October
November
December
2016
2017
2018
2019
Departure
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
January
February
March
April
May
June
July
August
September
October
November
December
2016
2017
2018
2019
2nd choice arrival
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
January
February
March
April
May
June
July
August
September
October
November
December
2016
2017
2018
2019
Departure
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
January
February
March
April
May
June
July
August
September
October
November
December
2016
2017
2018
2019
NUMBER OF FLAT 1st choice
1
1 or 6
2
3
2 or 3
4
5
6
8
10
Studio
1 Bedroom
....2nd choice
1
1 or 6
2
3
2 or 3
4
5
6
8
10
Studio
1 Bedroom
1 Title
Mr
Mrs
Miss
Ms
Rev
Dr
Other
Initial
Surname
Age if under 18
0-1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
2 Title
Mr
Mrs
Miss
Ms
Rev
Dr
Other
Initial
Surname
Age if under 18
0-1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
3 Title
Mr
Mrs
Miss
Ms
Rev
Dr
Other
Initial
Surname
Age if under 18
0-1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
4 Title
Mr
Mrs
Miss
Ms
Rev
Dr
Other
Initial
Surname
Age if under 18
0-1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
5 Title
Mr
Mrs
Miss
Ms
Rev
Dr
Other
Initial
Surname
Age if under 18
0-1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
6 Title
Mr
Mrs
Miss
Ms
Rev
Dr
Other
Initial
Surname
Age if under 18
0-1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
Bed Linen required
No
Yes
.........If yes Number of Beds (not people) ....Doubles
0
1
2
....Singles
0
1
2
3
4
Cot Required
No
Yes
.....Highchair Required
No
Yes
Central Heating Required
No
Yes
Space for ONE car........
No
Yes
If yes
............Make
Model
Body type eg hatchback, estate
I have read and agree to the terms & conditions of booking
YES
NO
Your name
Date
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
24
26
27
28
29
30
31
January
February
March
April
May
June
July
August
September
October
November
December
2016
2017
2018
2019
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
Yes
No
Deposit / Full payment of £
enclosed
Please make cheques payable to K. B. Hancock
Have you stayed with us before
No
Yes
...How did you discover our website
The owners reserve the right to refuse the application without stating a reason
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....................