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291 Bridge St
Toowoomba Q 4350
Ph: 07 4634 3299
Fax: 07 4634 3060
enquiries@bsmi.com.au
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| © 2010
Enquiries
Please complete this form so that we can confim booking requests or other details ...
* Indicates Required Field (Note: At Least one phone number must be supplied)
First Name *
Work Phone *
Last Name *
Home Phone *
Company
Fax
Street Address
Email *
City
Mobile *
State
Preferred Method of Contact
Work Phone
Home Phone
Mobile
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Post Code
Country
Arrival Date
March 2010
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Estimated Time of Arrival
Departure Date
March 2010
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Smoking
Yes
No
Number of Guests:
Adults
Children
Comments: