Reservation Request

Please complete the following information to make a reservation. Your reservation confirmation will be sent via email. Please call to guarantee room with your credit card number. If you do not call, your room will be held until 4 pm.

Name: Address: City: State:

Country: Zip Code: Telephone: E-mail:

Room Type Requested

Check desired room information

Please select one: Smoking | Non-Smoking | No Preference

Please check applicable: Need Handicap Room?

Date Needed... Month: January February March April May June July August September October November December Day: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 15 31 Year: 2006 2007 2008

Number of Nights Needed... 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 15 31

• Please include any additional information that you feel would be beneficial to us so that we can assist you in the most efficient manner.

Additional Comments

How did you come to visit Elizabeth Inn and Convention Center on the Web?
Repeat Customer Newspaper Magazine Personal Referral Business Card Search Engine Request Other