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KNICKERBOCKER LAKE COTTAGES

Reservation Request Form

NAME_______________________________________________________#adults____________

ADDRESS____________________________________________________#children__________

CITY,STATE,ZIP________________________________________PHONE__________________

#pets___________________ CELL PHONE __________________________________________

YOUR E-MAIL ADDRESS ________________________________________________________

Deposit amount enclosed_______________

For arrival Friday_______________, 2011 and departing Friday________________, 2011

(check one please)

White Cottage _____

Brown Cottage_____

Cedar Cottage_____

Chesuncook_______

Please mail to:

Bill and Paula Arsenault, PO Box 101, Boothbay, ME 04537

PLEASE MAKE CHECKS PAYABLE TO KNICKERBOCKER LAKE COTTAGES