| Reservation Form |
| Name: |
| Address: |
| Phone: |
| Fax: |
| Personal Information |
| Travel Details |
| Airline |
| Flight #: |
| Your expected arrival date: |
| Your expected departure date: |
| Phone: 718-981-0661 e-mail: [email protected] |
| # of guests: |
| Print and complete this page and mail with deposit |
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| To book a cottage, please mail deposit to: Francine Airall, 186 Fillmore St., Staten Island NY 10301 DEPOSIT $200.00 for stay up to six (6) days $360.00 for stay of one to three weeks $760.00 for stay of four weeks $1000.00 for stay of two months or more |
| Print and complete this page and mail with deposit |
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