Application Form

Christian name

Surname

Phone number

E-mail

Number of room(s)

1
2
3


Arrival date

Departure date

Special wishes

Casa Águas Mansas

Wim & Hetty Leenheer

Rua Principal No. 12
Nogueiras
3060-105 Cadima
Portugal

☎     +351 231422797
☏     +351 961908060
✉      w.j.leenheer@sapo.pt

www.aguas-mansas.com