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Rental Request Form

Fields marked with an asterisk* are required.
Your Contact Information:
*First Name:
Initial:
*Last Name:
*Street Address:
*City:
*State:
Zip:

*Daytime Phone: Best time to phone me:
Night Phone: Best time to phone me:
*Email:
 
Fax phone:
 
What led you to inquire about rentals from Shore & Country?
Your Rental Property Desires: Area/Location/requested:
Special facilities requested:
Property listing numbers and dates Desired:
First choice:
From:
To:
Second choice:
From:
To:
Number who will occupy the property at any one time:
Number of occupants sleeping over an any one time:
Minimum number of bedrooms required:
Minimum number of beds and sizes required: Doubles: Singles:
Your Desired Rental Price Range: Per week Price Minimum $ To Price Maximum $
Agree to Read the Conditions of Occupancy I have read and agree to abide by these provisions. Sample Conditions of Occupancy
Yes No

Thank you for providing the necessary information


 


Shore & Country Real Estate
Mailing: P.O. Box 69South Lyme, CT 06376
Office: 249 Shore Rd • Old Lyme, CT

www.CTBeach.com
info@CTBeach.com
1-888-CTBEACH
888-282-3224
860-434-1695


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