| Mr. G. May |
| CP 285N |
| Mogas, Nora |
| 8375-048 S.B. de Messines |
| Algarve |
| PORTUGAL |
Casa de Maio Payment Form |
|---|
| Name: ................................................................................................ |
| Address: ............................................................................................ |
| ........................................................................................................... |
| ........................................................................................................... |
| Post Code: ......................................................................................... |
| Tel: .......................................................................... |
| Fax: ......................................................................... |
| Email: ....................................................................... |
| Arrival Date: ............................................................ |
| Departure Date: ....................................................... |
| A Cheque for £ ..................... is enclosed for 1/3 deposit / 2/3 Balance / Payment in Full * |
| I, the undersigned, confirm that I am at least 18 years of age |
| Signed: ................................................................... |
| Date: ................................ |
| * Delete as appropriate. Please make cheques payable to Mr. G. May |
