RESERVATION REQUEST FORM

Please print & fax this reservation request form to: 814-838-3242.

Arrival Month: ____________ Day: ______________

Number of Nights:_______

Number of Adults:_______

Number Children:_______

Smoking Preference: ___ Smoking ___ Non-Smoking

Room Type: ___ Double ___ King ___ King Executive ___ Handicapped

Guest Name – First: ____________________
Last:____________________

Address: _________________________

_________________________

City: ______________________

State: _____________________

Zip: __________________

Country: _________________

Phone:___________________

Credit Card Type:

___ VISA ___ NOVUS CARDS ___ MASTERCARD ___ AMEX ___ DINER’S CLUB

Credit Card Number: __________________________

Exp Date:______________

Special Request Information: ____________________________________________

____________________________________________

Email Address: __________________________