CooperstownCottage

Rental Request Form 2010 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 4, 2010 June 11, 2010 June 18, 2010 June 25, 2010 July 2, 2010 July 09, 2010 July 16, 2010 July 23, 2010 July 30, 2010 August 6, 2010 August 13, 2010 August 20, 2010 August 27, 2010		Check Out Date	Select A Check-out Date June 11, 2010 June 18, 2010 June 25, 2010 July 2, 2010 July 09, 2010 July 16, 2010 July 23, 2010 July 30, 2010 August 6, 2010 August 13, 2010 August 20, 2010 August 27, 2010 September 3, 2010
	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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