Complete the Form below:
506 East 19th Avenue
Unit - 300, 3rd floor
North Wildwood, NJ
Rental Property Specifications
Building Type:
Condominium
Bedrooms:
5
Bathrooms:
3.5
Sleeps:
16
Bedding Information
Bedroom 1:
1 King
1 Queen Sleeper
Bedroom 2:
1 Queen
Bedroom 3:
1 Queen
Bedroom 4:
1 Double
Bedroom 5:
1 Queen
Living Room:
1 Queen Sleeper
Den:
2 Queen Sleeper
Personal Information:
* Required Information
First Name:*
Last Name:*
Address:
City/State/Zip:
Contact Information:
NOTE:
Entries are optional except for your select method of contact.
Best Way To Reach Me:
Anytime
Morning
Afternoon
By
Home Phone
Cell Phone
Office Phone
Email
Home Phone/Cell:*
Office Phone:
Cell Phone:
Fax Number:
E-mail Address:*
Have you had contact with anyone at Lees?
No
Yes
If yes, which agent:
Desired Dates:
Arrival Date:
Departure Date:
NOTE:
This vacation rental will sleep up to
16
people.
For My Party Of
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
Adults
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Children
Comments:
(No Special Characters)
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