Madeira Island Hotel Travel and Tourist Accommodation - Residentials of São Paulo and Alegria

Please note that fields indicated with a red asterisk like this one mean that the corresponding field is a "required field" to be filled in. That is, the form cannot be submitted without some required information to be included in the form as will be found below

Dates of Reservation:
Start Date:
End Date:
Year:	2007 2008 2009

Rooms (Prices per room)

	Please type in how many rooms you need of each
As a Double or Twin Bed
18 Rooms available	Minimum €40,00* per apartment*
How many people?
If necessary can we contact you to place a deposit on your accommodation ?	Yes No

Travel Information (if available):

	Flying in Not Flying in
Airline Name:
Flight # :


Personal Information:

Your Name:
Your eMail Address:
Your Address:
Your telephone number:
Your Fax Number ( if available):
Is it possible to tell us your Nationality or Language ?
If this accommodation is already taken can we notify you of alternative accommodation ?	Please tick if yes

Any questions or special requests ?
Please edit any query you might have in this box: