1. *:
2. First_Name:  *
3. Last_Name:  *
4. Phone:  *
5. Address:  *
6. Occupation:  *
7. First_language:  *
8. How_many_Rooms_available?:  *
9. Indicate_the_type_of_home:
10. Pick_up_at_the_airport?: Yes
No
11. To_the_city_CBD_by:
12. Room_available_from:  *
13. Monthly_fee:  *
14. Are_meals_included?: Yes
No
15. Other_Comments:  *
16. *:
17. Stay_term_(minimum):  (Week,Month)
18. Guest_from:
19. Acceptable_guest_age:  *
20. Sex: Male
Female
21. Are_smokers_allowed?: Yes
No
22. Email:
  *
23. Other_extra_information:

*