Farrell Clan Header Image

Accommodation Reservation Confirmation Form

If further details are required to confirm your reservation: Fill-in this form on-screen, Print it out and Mail or Fax it to:
NAME of YOUR ACCOMMODATION:

TYPE OF ROOM REQUESTED:
SMOKING NON-SMOKING

TYPE OF FACILITIES REQUESTED:
ENSUITE (In-room bathroom) NON-ENSUITE (shared)

TYPE OF OCCUPANCY REQUESTED:
SINGLE DOUBLE TRIPLE QUADRUPLE
Rate Quoted Per Room, Per Day in Euros €
YOUR NAME:

YOUR ADDRESS:

YOUR COUNTRY:

YOUR PHONE NUMBER(S) (Home & Business):

ARRIVAL DATE:      DAY:
DEPARTURE DATE: DAY:
NUMBER OF NIGHTS:
If applicable, type of Credit Card used: CARD NUMBER:
EXPIRY DATE:
SIGNATURE:_______________________________________
E-MAIL ADDRESS:(so the Accomodation can confirm receipt of your information.)
Send your comments or information for the site to will(a)farrellclanireland.com
History
Longford
Genealogy
Organization
Store
Join
History
Longford
Genealogy
Organization
Store
Join

Warning: include(http://willfarrell.ca/ar/send.php) [function.include]: failed to open stream: HTTP request failed! HTTP/1.1 500 Internal Server Error in /home/farrell/public_html/includes/footer.php on line 159

Warning: include() [function.include]: Failed opening 'http://willfarrell.ca/ar/send.php' for inclusion (include_path='.:/usr/lib/php:/usr/local/lib/php') in /home/farrell/public_html/includes/footer.php on line 159