Brussels Rentals
Boulevard d'Ypres, 92 - 1000 Brussels - Belgium
Tel: + 32 (0)2 209 29 50 - Portable : + 32 (0)477 29 45 11
Fax:  + 32 (0)2  209 29 59 
Admin@brussels-rentals.com

Information Demand Form to rent an Apartment

Type of accommodation / apartment / flat :
Rent
Duration of the stay 
Dates of your stay: From :
 ( dd/mm/yy )  Till :   
You wish
Iron Electrical Razor
Hair dry Furniture and accessories for children
Extra Services

Breakfast

Taxi service
Parking Cleaning and maintenance 
Fax Child bed
Laundry Supplementary house Linen
Vidéos Laundry service
Mobile telephone Baby-sitting
Travel agency Shopping service
Room service Other
                                
Remarks
Your co-ordinates 
Your e - mail
Your name
Your first name

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