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Southsea Lodge B&B Booking Request – Acommodation Agreement
Please book for me the following Bed & Breakfast accommodation.
Family Room	YES NO
Twin Room	YES NO
Single Room	YES NO
Double Room	YES NO
Extra Bed	YES NO
'Start / Check-In Date'	January Febuary March April May June July August September October November December 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 2008 2009 2010 Month - Day - Year
‘End / Check–Out Date’	January Febuary March April May June July August September October November December 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 2008 2009 2010 Month - Day - Year
This Booking is subject to the full Terms & Conditions (Click to view) I understand I will be charged for the Booking in accordance with the current Price List (Click to view) If you wish to pay by UK cheque or International Money Order, simply print off this Booking Form and post completed form with correct payment made payable to 'M May-Clingo’ and to: Southsea Lodge Bed & Breakfast, 27 Victoria Road North, SOUTHSEA, Hants, PO5 1PL, England.
I wish to pay by the following credit/debit card...	VISA Mastercard Switch JCB
Card Number	No spaces please Second box for Switch Card last 3 digits
Card expiry date	As shown on card
Card issue date	If shown on card
Issue Number (Switch only)
Security Code (3 digits on reverse of card)
Cardholders name
Company	(Optional)
Cardholders Address:	Line 1
	Line 2
	Town / City
	State / Province / County
	Zip / Post Code
	Country
Telephone number
E mail address
Despatch of your order will be confirmed by e.mail.
Additional information OR comments
To SUBMIT your Booking Request, click the green button now Confirmation of your Booking will be sent within 2 working days. This Booking Request is being sent to SouthseaLodge@aol.com
If you would prefer to fax this order, please print off now and do not 'SUBMIT'. Fax to the UK on +44 (0)23 9283 2069
To clear the Booking Form and re-enter data press 'RESET'
To exit the Booking Form Agreement without clicking 'SUBMIT' please use your 'BACK' button.
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Southsea Lodge Bed & Breakfast, 27 Victoria Road North, SOUTHSEA, PO5 1PL, England Telephone +44 (0)7050 074145 / +44 (0)77119 219926 Fax. +44 (0)23 9283 2069 E.mail Southsea Lodge