Arrival: ................................. Departure: ......................................

Room Requirement: Single Room         .........

                                  Double Room        ........

                                  Twin Room           .........

                                  Triple Room          .........

                                  Quadruple Room  .........

                                   Family Room       .........

                                  Children's Age (Family Room) ..........

Name: ................................

Address: ............................ Sate/Prov:        .......................................

City: .................................... Zip/{Postcode:   ......................................

Country: .............................

Method of Payment: Check .......... Visa .......... Master Card ...........

Credit Card Number:_________________________

Expire Date:             _________________________

Please send a deposit of one nights accommodation to:

Bakers Hotel
126 Warwick Way
London SW1V 4JA
Tel: 0207 834 0729
Fax: 0208 786 8105