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Veranda View Reservation Form

First name*:	Last name*:
Email address*:	Work phone number:
Home phone number:	Mobile phone number:
Address:
City:	State / Province / Region:
Country:	ZIP / Postal code:
Start Vacation	End Vacation
Number of persons	Room Type ............. one bedroom- Double bed one bedroom - double and single beds
Comments and questions*:
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Veranda View B&B Hermien Kuis Manager Calibishie, Dominica (767) 445-8900 or (767) 613-9493 e-mail: reserve@lodgingdominica.com

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This page was prepared by: K. Turner and Assoc. Magnetawan, Ontario Canada