Shelburne HarbourSide Cottages Reservation Form

1)	Name
2)	Street Address
3)	Address (Cont.)
4)	Phone
5)	E-Mail
6)	Number of People Staying
	1  2  3  4  5
7)	Number of Children Under the Age of 12
	1  2  3  4  5
8)	Number of Nights Requested
	1  2  3  4  5
9)	If Number of Nights is Greater than 5, Please Enter the Number Here
10)	Date of Arrival (mm/dd/yy)