Name:_________________________ Home Phone______-______________

Address:________________________________ City___________________

State_________ Zip___________ Day Phone______-_________ ext_______

If you know which unit you would prefer, please let us know: _______
Our rates vary based on the level of updating each unit owner has provided. Please refer to the unit you have requested and confirm this year's rate.

Unit size:________ # of people____ # of adults_____ # of children______

1/2 rental fee is necessary to confirm your reservation.

Payment may be mailed with a personal check or, for faster confirmation, may be charged to your credit card. We accept MasterCard, Visa and American Express. Please indicate if you would like all of your payments automatically applied to this card: yes [ ] no [ ]

Account number:____________________ Exp._____________

Name of cardholder:________________________

Signature if faxed __________________________

Note: We are unable to assist in making your automobile reservations for the Steamship Authority. Sengekontacket Vacation Rentals is no longer able to provide linen or equipment services. We would be happy to provide you with the necessary contact numbers for linen or equipment services on the island.