Please FILL IN THE FORM to request your stay.
We will respond via e-mail or phone to confirm your reservation.
Your Name:
Your E-mail:
Your Phone #:
Please tell us when you would like to arrive:
Arrival Month
January
February
March
April
May
June
July
August
September
October
November
December
Arrival Day
1
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18
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20
21
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23
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27
28
29
30
31
Please tell us when you would like to depart:
Departure Month
January
February
March
April
May
June
July
August
September
October
November
December
Departure Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
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23
24
25
26
27
28
29
30
31
Total Nights:
Total Adult Guests:
1
2
3
4
5
6
Total Children:
0
1
2
3
4
Please make any special requests or comments here.
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Brookings Beach Cottage ~
E-Mail
or phone (541) 469-6764
© 2002-07 ~ A Brookings Beach Cottage
Brookings/Harbor OR 97415 ~ All rights Reserved
