JEROME HOUSE, LONDON - Reservations Fax Enquiry / Confirmation for accommodation Please print off this form, complete as many details as possible IN BLACK INK and fax to: UK CODE+1494-441899. Only provide your credit card details if you wish to make a definite reservation If you do not receive a response within 24 hours please assume there is a communication problem and either refax or telephone:UK CODE(44)+1494-441760

SIGNED.................................................................
PRINT NAME:.......................................................

Name:	.
Email:	.
Fax Number:	.
Full Postal Address: .	.
Total # in party: .	.
Arrival date: .	.
Departure date: .	.
Number of nights: .	.
Apartment Size: .	.
Any special requirements ?: .	.
Price per night: .	.
Credit card #: .	.
Expiry Date: .	.