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Fields marked thus '*' are required.

First Name

     *
Surname      *
E-mail?      *
Arrival Date      *
Departure Date     *
Expected Time of Arrival      * Please Specify approx time
Telephone Number?      *
Fax Number?
Room Type      *
Street Address      *
       *
 

City

      *

Postal Code

What Country are you in?

      *
 

Any further comments

PLEASE NOTE THIS IS NOT A SECURE SERVER.
 If you submit your credit card details below it is entirely at your own risk. Cnoc Mhuire  Bed & Breakfast does not accept any responsibiliy for the inapproperiate use of credit card details. If in doubt please fax this form to us with all your details filled in to secure your booking.
 
Mastercard Visa
Credit Card Type

Credit Card Number

Expiry Date (MMYY)

Name on Credit Card

Please note that to secure a booking you must supply us with your credit card details. You can submit the credit card number via this form or for security reasons you may want to fax this form to us on +353 56 62161. 
To print this Form out with all your details filled in press this button

We operate a 48 hour cancellation policy.

Fields marked thus '*' are required.