Alpine Motel

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	Online Reservation Form
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Submission of this reservation form does not secure a reservation until we contact you to confirm your booking.
We will contact you to confirm your reservation and to obtain a credit card number to hold your reservation.

All fields marked with an * are required.

	Name	*
	Address	*
	City	*
	Province/State	*
	Country	*
	Postal / Zip Code	*

	Area Code - Phone #	*
	Area Code - Fax #	*
	Email Address	*
	Arrival Date MM/DD/YY	*
	Number of Nights	*
	Number of Adults	*
	Smoking Preference	Smoking Non-Smoking*
	Room Selection	Double
		Queen
		Kitchenette
		Adjoining Rooms
	Pets	Yes No

	Comments