Surname : Mr. Mrs. Miss First name : Address : Additional address : Post Code : City : Country : Country Australia (AU) Austria (AT) Belgium (BE) Brazil (BR) Bulgaria (BG) Canada (CA) Chile (CL) Croatia (HR) Czech Republic (CZ) Denmark (DK) Egypt (EG) Estonia (EE) Finland (FI) France (FR) Germany (DE) Greece (GR) Hong Kong (HK) Hungary (HU) Israel (IL) Italy (IT) Japan (JP) Luxembourg (LU) Malta (MT) Netherlands (NL) New Zealand (NZ) Norway (NO) Poland (PL) Portugal (PT) (UK) Russian Federation (RU) Saudi Arabia (SA) Singapore (SG) Slovakia (SK) Slovenia (SI) South Africa (ZA) South Korea (KR) Spain (ES) Sweden (SE) Switzerland (CH) Ukraine (UKR) United Arab Emirates (AE) United Kingdom USA (US) Others (****) Home telephone : Work telephone : E-mail : Fax : Brochure : Winter Summer language : German English French Italian Dutch Holiday dates (optional) : From 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2002 2003 2004 2005 to 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2002 2003 2004 2005 Number of adults and children over 5 years : Number of children less than 5 years : Type of lodgings : Apartment Camp ground Chalet Hotel Tourist residence Other Additional information :