Please enter your full name:

Enter your complete e-mail address:
( Example: Yourname@yourserver.com )

Enter YOUR complete mailing address:
( Example: 1521 Your Street, YourCity, YourState 12345 )

Daytime phone:

Evening phone:

FAX number:

Best time to call:
( Please Include Time Zone ! )

Arrival date (mm/dd/yy):

Alternate Arrival Date (mm/dd/yy):

Number of nights requested:

Select one property interested in:
3 BR Home - Don Pedro Island 2 BR Townhouse - Little Gasparilla Island 2 BR Condo - Madeira Beach 1 BR Condo - Manasota Key 2 BR Condo - Manasota Key 3 BR Home - Port Charlotte

Number of adults in party:
1 2 3 4 5 6

Number of children (18 and under) in party:
0 1 2 3 4 5 6

Any additional information or requirements:

I would prefer to be contacted by:
e-mail phone - anytime phone - day only phone - evening only FAX

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