Cozzy Housing Services Application

BOOKING FORM

Name

Surname

Date of Birth

Gender

Male Female Prefer Not To Say

Country of Origin

Email Adress

Phone Number

This is also my WhatsApp number

Employer Name

Check-In date

Check-Out date

Is Airport transfer required?

YES NO

Is bedding pack required?

YES NO

Does the guest have any health problem?

YES NO

Does the guest have any allergies?

YES NO

I Agree Terms & Conditions

I've read and agreed to the terms of service and cancellation policy. Click To Read

"YOU ARE REQUIRED TO SIGN THIS FIELD."

Location

COZZY HOUSING

200 Post Canyon Rd

Virginia Beach VA 23451

Phone

Tel.: 757-217-7325

Email

housing@cozzyhousing.com

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