e Reservierungsanfrage

Reservation Enquiry Form

Please make me a holiday offer for the period of:

Date:  Second date:

Persons:  Adults:  Children from age:

I am interested in:

Apartment 1     Apartment 2     Apartment 3

I need:

Garage

Extra bed

Baby´s bathtub

Cot

High chair

Baby´s dressing table
Name: First Name: Street:
Zip Code: City: Country:
Tel: Fax: eMail:

I am/We are Student(s) of the AKAD Lahr

I am/We are Family Members of a patient at the Lahr Heart Clinic

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