Enquiry & Booking Form

For the fastest response to your enquiry, please phone us on +61 8 85740043

Please complete the form below and send to us via the "Submit" link below.

If you prefer, you may print the form and send it by facsimile to +61 8 8574 0065.

If you have already booked, but would now like to make a credit card payment
- please go to our Secure Credit Card Payment Form

Your Name:
  
Postal Address:
  
Postcode:
  
Country:
  
Telephone:
  
Area Code:
Telephone 2:
  
Area Code:
Facsimile:
  
Email:
  
Is this your first visit to Poltalloch?
  
Preferred Cottage:
  
Arrival Date:
  
Departure Date:
  
Number of persons:
  
Adults
Children under 16 yrs
Infants (in own cot)
Breakfast provisions:
  
Estimated time of arrival:
  
from 3.00pm
Would you like a guided tour of Poltalloch?
  
How did you find this web site?
  
Additional requests or information:
  

Preferred Payment method:

  

credit card (Visa/Mastercard/Bankcard)
cheque/money order
We will contact you to confirm availability and let you know how to make a payment.