First & Last Name ________________________________________________
Date of arrival ____________________
Date of departure_________________
Guest names____________________________________________________
Address________________________________________________________
City ________________________ State ______ zip code _____________
Home Phone
_____________________
Work Phone _____________________
Cell Phone ________________________
E-mail _____________________________________
# of nights requested _________ # of guests _________
Arrival Time __________
Any pets?: Y ------ N
How many?: _________ What kind?:
___________________
Complimentary wine?: Y ------- N if yes,
white wine or red wine (please circle one)
Visa credit card #: ______________________________
Exp. date:___________
*cash, personal checks, money orders and
traveler's checks accepted
