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Restoule Cottage Rentals

Rental Application

Please note that all fields followed by an asterisk must be filled in.

First Name*
First Name*

Last Name*
Last Name*

Home Phone*
Home Phone*

Business Phone

E-mail Address

Street Address*
Street Address*

City*
City*

State/Prov*
State/Prov*

Zip/Postal Code*
Zip/Postal Code*

Country*
Country*

Fax

Cottage of Interest (first choice)*
Cottage of Interest (first choice)*

Cottage of Interest (second choice)*
Cottage of Interest (second choice)*

Requested Booking Dates - month

Days from -

to Day

I have previously rented a cottage from Loon Call Lane

Number of years at present address*
Number of years at present address*

	Rent
	Own

Employer's Name*
Employer's Name*

Employer's Address

Job Title*
Job Title*

Length of Employment

Driver's Licence Number*
Driver's Licence Number*

Licience Plate Number*
Licience Plate Number*

Occupant #1 Name*
Occupant #1 Name*

age*
age*

Occupant #2 name*
Occupant #2 name*

age

Occupant #3 name

age

Occupant #4 name

age

Occupant #5 name

age

Occupant #6 name

age

Are you bringing any day overnight guests?*
Are you bringing any day overnight guests?*

If yes, please provide names and dates

Will you be bringing any pets?*
Will you be bringing any pets?*

	cat
	dog

Number of pets (max number 2 additional cost $50.00/wk)

Smoking *note no smoking in cottages*
Smoking *note no smoking in cottages*

	Yes
	No

Are you familiar with Restoule?

Where did you hear about us?

Please enter the word that you see below.

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