CooperstownCottage

Rental Request Form 2011 Season
396 Tahmore Drive
Fairfield, CT 06825-2517
(203)374-0540

First Name			Last Name
Address			City
State	Select State ALABAMA ALASKA ARIZONA ARKANSAS CALIFORNIA COLORADO CONNECTICUT DELAWARE DISTRICT OF COLUMBIA FLORIDA GEORGIA HAWAII IDAHO ILLINOIS INDIANA IOWA KANSAS KENTUCKY LOUISIANA MAINE MARYLAND MASSACHUSETTS MICHIGAN MINNESOTA MISSISSIPPI MISSOURI MONTANA NEBRASKA NEVADA NEW HAMPSHIRE NEW JERSEY NEW MEXICO NEW YORK NORTH CAROLINA NORTH DAKOTA OHIO OKLAHOMA PENNSYLVANIA RHODE ISLAND SOUTH CAROLINA SOUTH DAKOTA TENNESSEE TEXAS UTAH VERMONT VIRGINIA WASHINGTON WEST VIRGINIA WISCONSIN WYOMING		Zip Code
Phone			Cell Phone
Email			Verify Email
Check In Date	Select A Check-in Date June 03, 2011 June 10, 2011 June 17, 2011 June 24, 2011 July 01, 2011 July 08, 2011 July 15, 2011 July 22, 2011 July 29, 2011 August 05, 2011 August 12, 2011 August 19, 2011 August 26, 2011		Check Out Date	Select A Check-out Date June 10, 2011 June 17, 2011 June 24, 2011 July 01, 2011 July 08, 2011 July 15, 2011 July 22, 2011 July 29, 2011 August 05, 2011 August 12, 2011 August 19, 2011 August 26, 2011 September 02, 2011
	Check In Time after 4:00 PM			Check Out Time before 9:00 AM
Select Property	Diane's Dream House			The Lake House
	The McClure House			The Buena Vista House
	Select Number of Adults One Two Three Four Five Six Seven Eight			Children under 18 Zero One Two Three Four Five Six Seven
Comments/Team Name:
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