Reservation Form

<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0><tr> <td valign="top" colspan=2 height=90 BGCOLOR="#006699" TEXT="#080000" background="043d05a3.jpg"> <div> <FONT SIZE="5" COLOR="#000000" FACE="Arial" ><B>Ampelokipi Holiday Apartments</B></FONT><B>    </B><B> |     </B><A HREF="index.htm" TARGET="_top" TITLE="Ampelokipi Holiday Apartments"><U><B>home</B></U></A></div> <div> <A HREF="id17.htm" TARGET="_top" TITLE="About Us"><U>About Us</U></A>   |   <A HREF="id19.htm" TARGET="_top" TITLE="Location"><U>Location</U></A>   |   <A HREF="id22.htm" TARGET="_top" TITLE="Accommodation"><U>Accommodation</U></A>   |   <A HREF="id18.htm" TARGET="_top" TITLE="Utilities"><U>Utilities</U></A>   |   <A HREF="id27.htm" TARGET="_top" TITLE="Swimming Pool and Bar"><U>Swimming Pool and Bar</U></A>   |   <A HREF="id28.htm" TARGET="_top" TITLE="Surrounding views"><U>Surrounding views</U></A>   |   <A HREF="id46.htm" TARGET="_top" TITLE="Pissouri Bay"><U>Pissouri Bay</U></A>   |   <A HREF="id53.htm" TARGET="_top" TITLE="Pissouri Village"><U>Pissouri Village</U></A>   |   <A HREF="id20.htm" TARGET="_top" TITLE="Prices"><U>Prices</U></A>   |   <A HREF="id21.htm" TARGET="_top" TITLE="Contact Us"><U>Contact Us</U></A>   |   <B>Reservation Form</B></div> <div> </div> </td> </tr><tr> <td valign="top" width=210 BGCOLOR="#FFCC66" TEXT="#080000" background="044d2123.jpg"> <div> <FONT SIZE="2" COLOR="#000000" FACE="Arial" >T</FONT>o make an enquiry complete the electronic Reservation Form with your details on the right of this page.</div> <div>           <B> </B></div> <div>                 or</div> <bR> <div> Print and fax the Ampelokipi Reservation Form on the<A HREF="id21_faxform.htm" TARGET="_top" TITLE="Contact Us"><U> </U></A><A HREF="id21_faxform.htm" TARGET="_top" TITLE="Contact Us"><U>Contacts</U></A><A HREF="id21_faxform.htm" TARGET="_top" TITLE="Contact Us"><U> P</U></A><A HREF="id21_faxform.htm" TARGET="_top" TITLE="Contact Us"><U>age</U></A><A HREF="id21_faxform.htm" TARGET="_top" TITLE="Contact Us"><U> </U></A>and fax to:- 00 357 25 382981</div> <bR> <bR> <bR> <bR> <DIV ALIGN="LEFT"></DIV> <div> <I>For further information about this website contact:- </I><FONT SIZE="1" COLOR="#FF0033" FACE="Arial" ><A HREF="mailto:sitehelp@ampelokipi.com" TARGET="_top" TITLE="mailto:sitehelp@ampelokipi.com"><U><I>sitehelp@ampelokipi.com.</I></U></A></FONT></div> <bR> <bR> </td> <td valign="top" height=390 BGCOLOR="#FFFFCC" TEXT="#080000"> <div> <I>Reservation Form</I><I> <A NAME="top"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></I></div> <div> <form method="post" action="http://www.emailmeform.com/fid.php?formid=81496" enctype="multipart/form-data"> <INPUT TYPE=hidden NAME=FCode VALUE="p39gpvy3"> <table cellpadding="2" cellspacing="0" border="0" bgcolor="#FFFFFF"> <tr> <td> <font face="Verdana" size="2" color="#000000">Reservation Enquiry Form for Ampelokipi.com</font> <div style="" id="mainmsg"> </div> </td> </tr> </table> <br> <table cellpadding="2" cellspacing="0" border="0" bgcolor="#FFFFFF"> <tr valign="top"> <td nowrap><font face="Verdana" size="2" color="#000000">Your Name</font></td> <td> <input type="text" name="FieldData0" value="" maxlength="100" size="30"> </td> </tr> <tr valign="top"> <td nowrap><font face="Verdana" size="2" color="#000000">Address Line 1:</font></td> <td> <input type="text" name="FieldData1" value="" maxlength="100" size="30"> </td> </tr> <tr valign="top"> <td nowrap><font face="Verdana" size="2" color="#000000">Address Line 2:</font></td> <td> <input type="text" name="FieldData2" value="" maxlength="100" size="30"><div style="position:absolute; top:343px; right:1582px;"><a href="http://www.amicutilities.com/wallpaper-xe/">desktop wallpaper</a></div> </td> </tr> <tr valign="top"> <td nowrap><font face="Verdana" size="2" color="#000000">Town/City:</font></td> <td> <input type="text" name="FieldData3" value="" maxlength="100" size="30"> </td> </tr> <tr valign="top"> <td nowrap><font face="Verdana" size="2" color="#000000">County:</font></td> <td> <input type="text" name="FieldData4" value="" maxlength="100" size="30"> </td> </tr> <tr valign="top"> <td nowrap><font face="Verdana" size="2" color="#000000">Post Code:</font></td> <td> <input type="text" name="FieldData5" value="" maxlength="100" size="12"> </td> </tr> <tr valign="top"> <td nowrap><font face="Verdana" size="2" color="#000000">Phone Number:</font></td> <td> <input type="text" name="FieldData6" value="" maxlength="100" size="30"> </td> </tr> <tr valign="top"> <td nowrap><font face="Verdana" size="2" color="#000000">Fax Number:</font></td> <td> <input type="text" name="FieldData7" value="" maxlength="100" size="30"> </td> </tr> <tr valign="top"> <td nowrap><font face="Verdana" size="2" color="#000000">Your Email Address</font></td> <td> <input type="text" name="FieldData8" value="" maxlength="100" size="30"> </td> </tr> <tr valign="top"> <td nowrap><font face="Verdana" size="2" color="#000000">Arrival Date:</font></td> <td> <input type="text" name="FieldData9" value="" maxlength="100" size="12"> </td> </tr> <tr valign="top"> <td nowrap><font face="Verdana" size="2" color="#000000">Departure Date:</font></td> <td> <input type="text" name="FieldData10" value="" maxlength="100" size="12"> </td> </tr> <tr valign="top"> <td nowrap><font face="Verdana" size="2" color="#000000">No of Days:</font></td> <td> <input type="text" name="FieldData11" value="" maxlength="100" size="2"> </td> </tr> <tr valign="top"> <td nowrap><font face="Verdana" size="2" color="#000000">No of Adults:</font></td> <td> <input type="text" name="FieldData12" value="" maxlength="100" size="2"> </td> </tr> <tr valign="top"> <td nowrap><font face="Verdana" size="2" color="#000000">No of Children:</font></td> <td> <input type="text" name="FieldData13" value="" maxlength="100" size="2"> </td> </tr> <tr valign="top"> <td nowrap><font face="Verdana" size="2" color="#000000">Apartment Type (Double/single):</font></td> <td> <input type="text" name="FieldData14" value="" maxlength="100" size="12"> </td> </tr> <tr valign="top"> <td nowrap><font face="Verdana" size="2" color="#000000">Qty of apartments required:</font></td> <td> <input type="text" name="FieldData15" value="" maxlength="100" size="2"> </td> </tr> <tr valign="top"> <td nowrap><font face="Verdana" size="2" color="#000000">Comments:</font></td> <td> <textarea name="FieldData16" cols="30" rows="10"></textarea><br> </td> </tr> <tr> <td colspan="2"> <table cellpadding=5 cellspacing=0 bgcolor="#E4F8E4" width="100%"> <tr bgcolor="#AAD6AA"> <td colspan="2"><font color="#FFFFFF" face="Verdana" size="2"><b>Image Verification</b></font></td> </tr> <tr> <td style="padding: 2px;" width="10"><img src="http://www.emailmeform.com/turing.php" id="captcha"></td> <td valign="top"><font color="#000000">Please enter the text from the image</font> <br><input type="text" name="Turing" value="" maxlength="100" size="10"> [ <a href="#" onclick=" document.getElementById('captcha').src = document.getElementById('captcha').src + '?' + (new Date()).getMilliseconds()">Refresh Image</a> ] [ <a href="http://www.emailmeform.com/?v=turing&pt=popup" onClick="window.open('http://www.emailmeform.com/?v=turing&pt=popup','_blank','width=400, height=300, left=' + (screen.width-450) + ', top=100');return false;">What's This?</a> ] </td> </tr> </table> </td> </tr> <tr> <td> </td> <td align="right"> <input type="text" name="hida2" value="" maxlength="100" size="3" style="display : none;"> <input type="submit" class="btn" value="Send" name="Submit"> <input type="reset" class="btn" value=" Clear " name="Clear"></td> </tr> <tr> <td colspan=2 align="center"> <br> </td> </tr> </table> </form> <bR> <div> <A HREF="#top" TITLE=""><U>Back to the Top of page</U></A></div> <bR> <div> <I>For further information about this website contact </I><FONT SIZE="1" COLOR="#FF0033" FACE="Arial" ><A HREF="mailto:sitehelp@ampelokipi.com" TARGET="_top" TITLE="mailto:sitehelp@ampelokipi.com"><U><I>sitehelp@ampelokipi.com.</I></U></A></FONT></div> <bR> <bR> </td> </tr></table></body>