Request Appartment

In order to make a reservation, please agree to the cookies!

Your personal details

Salutation(*)

MrsMr

Ungültige Eingabe

First name(*)

Ungültige Eingabe

Last Name(*)

Please let us know your name.

Street(*)

Please write a Street

PLZ(*)

Please write a subject for your message.

City(*)

Please write a City

Your Phone(*)

Please let us know your phone

Your Email(*)

Please let us know your email address.

Details of the desired reservation

Amount of people(*)

Bitte tragen Sie die Anzahl der Zimmer ein

Arrival(*)

...

Invalid Input

Departure(*)

...

Invalid Input

Message

Please let us know your message.

Data protection(*)

Accept data protection regulations. I agree that my personal data may be processed and used by the Arbeiter-Samariter-Bund Baden-Württemberg e.V. Region Pforzheim for the purpose of my further support and, if necessary, the sending of information. Your data will not be passed on to third parties and personal data will not be sold. I can object to the processing or use of my data at any time by contacting the Arbeiter-Samariter-Bund Baden-Württemberg e.V. Region Pforzheim. The correction, blocking or deletion of your personal data is possible at any time.

Ungültige Eingabe

If you do not see the captcha field you agree to the cookies!

(*)

Invalid Input

Send