Booking  Form

Please book by filling in the form below so that we can fulfill your requirements.  
Your booking will be reserved for 5 days whilst you send the deposit by post 
and will be confirmed in writing on receipt of the deposit. 
 This form may be sent to us on-line or printed and sent in the normal way.
  Please make cheques payable to:
 I M Lewis,  Cilgwyn, Cefnllan, Llanbadarn Fawr, Aberystwyth SY23 3TF 
         Telephone / Answerphone / Fax : 01970 612683

Name
Street 
Town/City County/State
Post Code/Zip Country if outside UK
Telephone  Fax Number
E_Mail 
 

 

Reservation:

- Pantymansial

- Erw Beili

- Both
 

Dates :

 One Week

Commencing:

Two Weeks

Three Weeks  

Short Break

  

Please check availability with us before selecting Short Break
 
Adult 1-6

 

 
Child 0-5

   
Pets 0-1

   
 
Baby / Toddler Requirements:

- Cot

- High Chair

 

Total Cost:
weeks @ £   £
Short Break @ £   £
weeks for 1 pet@ £   £
     

TOTAL: £
   

Payment : 

    
Deposit Enclosed

£
Paid

£

 Deposit is 30% of total costs with a minimum of £50
 Balance: Enclosed

£
  Due

£

Balance is due one month before the start of your holiday


Please tell us where you heard about us?
- Stayed Previously
- Recommendation

- Brochure
- Press
- Internet
- Other