First Name
Surname
Email Address
Contact Number
Street Address
Town/Suburb
Country
Arrival Date
Departure Date
Pick up Location (eg. Airport) if needed
Duration of Stay
Unit Required
Select Unit Unit 1 Unit 2 Unit 3
Comments and/or requirements
Banking Details
Bank : First National Bank
Account name : Grassy Knoll T/A Pelican Accommodation
Account no : 62071831921
Type of account: Cheque Account
Branch code : 203 209
Branch : Lansdowne
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