Please use this form to request reservations and information

We're looking forward to hosting you at Santosha On The Ridge Bed and Breakfast. Please provide as much information as possible on the form below so we can get you the right room, the right dates, and accommodate any special requests you might have. Once we've checked final availability, we'll call you or contact you via e-mail to complete the transaction.

If you want to use the form to request specific rooms and/or dates, follow these three simple steps:

1	Check room availability here.
2	Fill out the information request form below (Clients need to type a phone # or email to be contacted)
3	Click the "submit" button at the bottom of the form

We'll contact you right away to discuss your request and needs. We won't need a credit card to hold the room(s) until we've
made sure we can accommodate your request.

Fill out the following information (bold fields are mandatory) and click 'Submit'.

First Name:

Last Name:

Company:

Address 1:

Address 2:

City: State: Zip: Telephone:

Fax: E-mail: Cell phone:

Have you stayed with us before?:
Yes
No

Are you interested in a specifc room or rooms?:
Naturescape: $200.00
Sunrise: $185.00 (second floor)
River View: $160.00 (second floor)
Woodland Vale: $145.00 (main floor)
Which date(s ) are you interested in?:

Guest Name(s):

Do you have any special requests?:

Do you have any special dietary needs or allergies?:
Please tell us how you learned about us:
Internet/search engine
Our web site
Print advertising
Tour
A friend told me about you

Other (please indicate below:


How should we contact you?:
Please contact me at the phone number(s) above
Please contact me only by e-mail
Either phone or e-mail is fine
Referred by:

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Santosha on the Ridge, LLC, located in Shawnee On The Delaware • A Bed & Breakfast Sanctuary • RR21, Box 6154 • Mosiers Knob Rd • East Stroudsburg, PA 18301 • 570-476-0203 • Fax 570-476-0205 • inquiry@santoshaontheridge.com