If you want to spent your holiday on our wine farm, please fill in this application form. Fields marked with a star (*) are compulsary.
name*
street, no.*
town*
phone number*
fax number
e-mail-address
Please send me/us a brochure of the holiday appartment.
yes
no
I want to book the holiday appartment for
1 person
2 persons
3 persons
4 persons
5 persons
6 persons
.
children among:
arrival date
.
.
departure date
.
.
notes:
Back to our
homepage
.
used form mailer:
Nether-Mail
.