Contact Form
Au Jardin Helvetia
Contact/15-en
©Heiner H. Schmitt
Cotonou & Basel
09.06.2007
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Contactform
,
for requests about aditional informations.
If you want to make a provisonal or final reservation, as well as room requests, we recommend you to use the
Form for a provisional reservation in 'Au Jardin Helvetia', Cotonou
==>
Reservation
Please fill out the form, the
bold
marked fields are compulsory !
A confirmation will automatically be sent to your given e-mail address.
Title
Missis
Mister
Miss
Mistriss
Firstname
Name
Already guest in
AJH
@
(mm.yyyy)
POB
Street
PLZ
City
Country/State
E-mail
Phone private
Office/Mobile
Fax
- Request for
Au Jardin Helvetia
:
Before
"==> verification"
, please transmit the code below in the code field (Cd) aside (Spamreduction)
==>
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