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Poconos Vacation House
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*Required

PERSONAL INFORMATION

*First Name
Last Name
*Email Address
*Phone # (Daytime)
*Phone # (Evening)
Address
City
State
Country
Zip/Postal Code

ABOUT YOUR STAY

Arrival Day
Checkout Day
Number of Adults
Number/Ages of Kids
Describe Your Stay
Budget Information
Property Interested In:
Special Needs

MESSAGE AREA

Tell us as much as you can about your vacation plans,
budget, interests, and how and when you prefer to be contacted.


Tell us how you heard about us.  Please be specific.
I would like to receive email specials about your properties.

All information is kept in strictest confidence. Your personal infomation is used to provide information with the property owner and is not shared with any other party, nor used for any other purpose.

For reservations or more information about our Poconos Vacation House, please complete the reservation form or contact LARRY at 1- 917-558-7575.
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Poconos Vacation House

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