Circa 1870-Bed & Breakfast: Request For Reservation

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Airline:

Flight Number:

Estimated Arrial Time:

Arrival Date:

Departure Date:

Number of Guests:

Business or Leisure:

I would prefer the:

New York Room

King Room

Yellow Room

Rosie Room

Twins Room

Name: *

Address:

City:

State:

Zip:

Phone (including Area Code)

* Home:

* Work:

* Fax:

* Email:

* To receive a response, please fill out at least one of these fields (Phone, Fax, or Email).

Additional Comments:

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