2011 Brownland Farm Online Reservation Form



Name:	*
Email Address:
(We respect your privacy and will not give your email address to any third party)
Farm/Barn:
Mailing Address:	*

City:	*
State:	*
Zip / Postal Code:	*
Daytime Phone Number:	*
Fax Number:

Arrival Date (mo/day/yr):	*
Departure Date (mo/day/yr):	*
Hotel (Choice #1):
Hotel (Choice #2):
Number of Rooms:	*
Room Type:
King / Queen
2 Doubles
Room Preference:
Smoking
Non Smoking

Method of Payment
Credit Card Number	*
(Your credit card will not be charged. This is to guarantee a hotel reservation only.)
Expiration Date	*
Cardholders Name (as it appears on card):	*

* Denotes required fields.
This site is secured. If you do not submit a credit card, your room will not be confirmed
Check the information that you have just entered, and make changes if necessary. When you are satisfied that everything is correct, press the SUBMIT button.
A confirmation will be emailed to you. If Hotel Choice 1 & 2 are sold out, we will email you options.